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VTE PREVENTION: UNDERSTANDING CURRENT STRATEGIES

Today's options for thromboprophylaxis

Anticoagulants and mechanical thromboprophylaxis
devices

For postsurgical orthopedic patients, specifically in cases of total hip replacement (THR) and total knee replacement (TKR), current American Academy of Orthopedic Surgeons (AAOS) and American College of Chest Physicians (ACCP) guidelines recommend pharmacologic and mechanical thromboprophylaxis as standard options for VTE prevention.3,4

A review of the most recent AAOS and ACCP guidelines can offer key insights into the efficacy and limitations of current strategies of VTE prophylaxis.

  • Anticoagulants are the cornerstones of thromboprophylaxis for VTE. A large number of randomized clinical trials provides evidence that appropriately used thromboprophylaxis reduces the incidence of VTE.18
  • Mechanical thromboprophylaxis devices, including graduated compression stockings, intermittent pneumatic compression, and venous foot pumps, are recommended by current guidelines in patients at high risk of bleeding, or as an adjunct to anticoagulant-based prophylaxis; however, these devices are often associated
    with3,8:
    • Poor patient compliance
    • Considerable costs related to their purchase and maintenance