[Postoperative recurrence of venous thromboembolism in patients with episodes of preoperative thromboembolism].
BACKGROUND
Venous thromboembolism (VTE) has become a major health problem in Japan.


METHODS
We examined, postoperative recurrence of VTE in patients with preoperative venous thromboembolic events and evaluated factors that are relevant to the occurrence of postoperative VTE.


RESULTS
Forty-four cases out of 38500 had been diagnosed preoperatively as having VTE in the period of 1995-2001 at Kitasato University Hospital. Postoperative VTE was detected in four patients (9%) out of these 44 cases. Patients who had thrombophilia (antiphosholipid syndrome) or recent episode of VTE within 1 month were higher in the incidence of postoperative recurrence of VTE than the others. Temporary infra-vena cava filters were placed to prevent pulmonary thromboembolism in twelve patients. In 8 of the patients, thrombi were detected in or at the filter before explantation. Three patients (7%) had undergone thrombolysis therapy. Postoperative VTE was not found in patients who had already received anticoagulant therapy (warfarin) for 3 or more months.


CONCLUSIONS
It is concluded that newly developed VTE occurred perioperatively in 9% of patients with preoperative VTE, and that thrombophilia and a recent episode of VTE were considered as risk factors of perioperative VTE. Temporary infra-vena cava filters are a valuable device for prevention of postoperative pulmonary thromboembolism.
Kuroiwa
Masayuki
M
Department of Anesthesiology, Kitasato University, School of Medicine, Sagamihara 228-8555.
Arai
Masayasu
M
Nakahara
Eri
E
Hoka
Sumio
S
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage; D016736:Antiphospholipid Syndrome / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012008:Recurrence; D012307:Risk Factors; D013923:Thromboembolism / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control; D015912:Thrombolytic Therapy; D016306:Vena Cava Filters; D020246:Venous Thrombosis / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control; D014859:Warfarin / Q000008:administration & dosage
D000925:Anticoagulants; D014859:Warfarin