Deep venous thrombosis in postoperative vascular surgical patients: a frequent finding without prophylaxis

Abstract

Purpose: The place of routine perioperative thromboprophylaxis for vascular surgical patients remains controversial, because the incidence of postoperative deep venous thrombosis (DVT) is said to be quite low. This study was designed to measure the incidence of lower limb DVT after vascular surgical procedures.

Methods: All consenting, consecutive patients who came to a metropolitan veterans hospital for abdominal or lower-limb arterial surgery were studied. Clinical and operative data were recorded. Lower-limb color flow duplex scans were performed before and after surgery.

Results: Fifty patients, age 75 +/- 1 (mean +/- SEM) years, were studied. Abdominal procedures were performed on 22 patients, and lower-limb procedures were performed on 28 patients. A postoperative DVT was noted in 14 patients (32%), 9 patients (41%) in the abdominal surgical group and 5 patients (18%) in the lower-limb group. Calf DVTs were four times more common than femoropopliteal DVTs.

Conclusion: The incidence of postoperative lower-limb DVTs in this cohort of vascular surgical patients was high. The small size of the study population precludes generalized recommendations, but the results indicate an urgent need for definitive investigation.