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Prevention of venous thromboembolism in patients undergoing bariatric surgery

Authors Bartlett M, Mauck K, Daniels P

Received 15 May 2015

Accepted for publication 22 June 2015

Published 17 August 2015 Volume 2015:11 Pages 461—477

DOI https://doi.org/10.2147/VHRM.S73799

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Prof. Dr. Amudha Kadirvelu

Peer reviewer comments 2

Editor who approved publication: Dr Daniel Duprez


Matthew A Bartlett, Karen F Mauck, Paul R Daniels

Division of General Internal Medicine, Mayo Clinic Thrombophilia Center, Department of Medicine, Mayo Clinic, Rochester, MN, USA

Abstract: Bariatric surgical procedures are now a common method of obesity treatment with established effectiveness. Venous thromboembolism (VTE) events, which include deep vein thrombosis and pulmonary embolism, are an important source of postoperative morbidity and mortality among bariatric surgery patients. Due to an understanding of the frequency and seriousness of these complications, bariatric surgery patients typically receive some method of VTE prophylaxis with lower extremity compression, pharmacologic prophylaxis, or both. However, the optimal approach in these patients is unclear, with multiple open questions. In particular, strategies of adjusted-dose heparins, postdischarge anticoagulant prophylaxis, and the role of vena cava filters have been evaluated, but only to a limited extent. In contrast to other types of operations, the literature regarding VTE prophylaxis in bariatric surgery is notable for a dearth of prospective, randomized clinical trials, and current professional guidelines reflect the uncertainties in this literature. Herein, we summarize the available evidence after systematic review of the literature regarding approaches to VTE prevention in bariatric surgery. Identification of risk factors for VTE in the bariatric surgery population, analysis of the effectiveness of methods used for prophylaxis, and an overview of published guidelines are presented.

Keywords: bariatric surgery, venous thromboembolism, prophylaxis, vena cava filter, heparin

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