Antithrombotic prophylaxis for surgery-associated venous thromboembolism risk disorders. In patients the SPATA-DVT with inherited study platelet

• Autores: Paciullo, Francesco; Bury, Loredana; Noris, Patrizia; Falcinelli, Emanuela; Melazzini, Federica; Orsini, Sara; Zaninetti, Carlo; Abdul-Kadir, Rezan; Obeng-Tuudah, Deborah; Heller, Paula Graciela; Glembotsky, Ana Claudia; Fabris, Fabrizio; Rivera, Jose; Lozano, Maria Luisa; Butta, Nora; Favier, Remi; Cid, Ana Rosa; Fouassier, Marc; Podda, Gian Marco; Santoro, Cristina; Grandone, Elvira; Henskens, Yvonne; Nurden, Paquita; Zieger, Barbara; Cuker, Adam; Devreese, Katrien; Tosetto, Alberto; de Candia, Erica; Dupuis, Arnaud; Miyazaki, Koji; Othman, Maha; Gresele, Paolo
• Año de publicación: 2019
• Idioma: inglés
• Tipo de recurso: artículo
• Materia: Antithrombotic Therapy; Disorders of Platelet Function; Platelets; Venous Thrombosis
• Institución: Consejo Nacional de Investigaciones Científicas y Técnicas

Major surgery is associated with an increased risk of venous thromboembolism (VTE), thus the application of mechanical or pharmacologic prophylaxis is recommended. The incidence of VTE in patients with inherited platelet disorders (IPD) undergoing surgical procedures is unknown and no information on the current use and safety of thromboprophylaxis, particularly of low-molecular-weight-heparin in these patients is available. Here we explored the approach to thromboprophylaxis and thrombotic outcomes in IPD patients undergoing surgery at VTE-risk participating in the multicenter SPATA study. We evaluated 210 surgical procedures carried out in 155 patients with well-defined forms of IPD (VTE-risk: 31% high, 28.6% intermediate, 25.2% low, 15.2% very low). The use of thromboprophylaxis was low (23.3% of procedures), with higher prevalence in orthopedic and gynecological surgeries, and was related to VTE-risk. The most frequently employed thromboprophylaxis was mechanical and appeared to be effective, as no patients developed thrombosis, including patients belonging to the highest VTE-risk classes. Low-molecular-weight-heparin use was low (10.5%) and it did not influence the incidence of post-surgical bleeding or of antihemorrhagic prohemostatic interventions use. Two thromboembolic events were registered, both occurring after high VTE-risk procedures in patients who did not receive thromboprophylaxis (4.7%). Our findings suggest that VTE incidence is low in patients with IPD undergoing surgery at VTE-risk and that it is predicted by the Caprini score. Mechanical thromboprophylaxis may be of benefit in patients with IPD undergoing invasive procedures at VTE-risk and low-molecular-weight-heparin should be considered for major surgery.
Fil: Paciullo, Francesco. Università di Perugia; Italia
Fil: Bury, Loredana. Università di Perugia; Italia
Fil: Noris, Patrizia. Universita Degli Studi Di Pavia; Italia
Fil: Falcinelli, Emanuela. Università di Perugia; Italia
Fil: Melazzini, Federica. Universita Degli Studi Di Pavia; Italia
Fil: Orsini, Sara. Università di Perugia; Italia
Fil: Zaninetti, Carlo. Universita Degli Studi Di Pavia; Italia
Fil: Abdul-Kadir, Rezan. Colegio Universitario de Londres; Reino Unido
Fil: Obeng-Tuudah, Deborah. Colegio Universitario de Londres; Reino Unido
Fil: Heller, Paula Graciela. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina
Fil: Glembotsky, Ana Claudia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina
Fil: Fabris, Fabrizio. Azienda Ospedaliera Di Padova; Italia
Fil: Rivera, Jose. Hospital Universitario Morales Meseguery; España. Universidad de Murcia; España
Fil: Lozano, Maria Luisa. Hospital Universitario Morales Meseguery; España. Universidad de Murcia; España
Fil: Butta, Nora. Instituto de Investigacion del Hospital de la Paz.; España
Fil: Favier, Remi. Armand Trousseau Children’s Hospital; Francia
Fil: Cid, Ana Rosa. Hospital Universitario y Politecnico La Fe; España
Fil: Fouassier, Marc. CHU de Nantes; Francia
Fil: Podda, Gian Marco. Università degli Studi di Milano; Italia
Fil: Santoro, Cristina. Università degli studi di Roma "La Sapienza"; Italia
Fil: Grandone, Elvira. Istituto Nazionale di Ricovero e Cura a Carattere Scientifico "Saverio de Bellis"; Italia. Moscow State Medical University; Rusia
Fil: Henskens, Yvonne. Maastricht University Medical Centre; Países Bajos
Fil: Nurden, Paquita. Hospital Universitario Morales Meseguery; España. Universidad de Murcia; España
Fil: Zieger, Barbara. Albert Ludwigs University of Freiburg; Alemania
Fil: Cuker, Adam. University of Pennsylvania; Estados Unidos
Fil: Devreese, Katrien. University of Ghent; Bélgica
Fil: Tosetto, Alberto. Ospedale San Bortolo; Italia
Fil: de Candia, Erica. Università Cattolica del Sacro Cuore; Italia. Istituto Nazionale di Ricovero e Cura a Carattere Scientifico "Saverio de Bellis"; Italia
Fil: Dupuis, Arnaud. Université de Strasbourg; Francia
Fil: Miyazaki, Koji. Kitasato University; Japón
Fil: Othman, Maha. Queens University; Canadá
Fil: Gresele, Paolo. Università di Perugia; Italia