Thrombosis prevention

This article is about preventing blood clots. For how blood clots form, see Thrombosis. For information on blood clots in the legs, see Deep vein thrombosis.

Thrombosis prevention
A blood clot blocking a blood vessel.
Other namesThrombosis prophylaxis
ICD-10-PCSI80-I82
ICD-9-CM437.6, 453, 671.5, 671.9

Thrombosis prevention or thromboprophylaxis is medical treatment to prevent the development of thrombosis (blood clots inside blood vessels) in those considered at risk for developing thrombosis.[1] Some people are at a higher risk for the formation of blood clots than others, such as those with cancer undergoing a surgical procedure.[2][3] Prevention measures or interventions are usually begun after surgery as the associated immobility will increase a person's risk.[4]

Blood thinners are used to prevent clots, these blood thinners have different effectiveness and safety profiles. A 2018 systematic review found 20 studies that included 9771 people with cancer. The evidence did not identify any difference between the effects of different blood thinners on death, developing a clot, or bleeding.[2] A 2021 review found that low molecular weight heparin (LMWH) was superior to unfractionated heparin in the initial treatment of venous thromboembolism for people with cancer.[3]

There are medication-based interventions and non-medication-based interventions.[4] The risk of developing blood clots can be lowered by life style modifications, the discontinuation of oral contraceptives, and weight loss. In those at high risk both interventions are often used.[1] The treatments to prevent the formation of blood clots is balanced against the risk of bleeding.[5]

One of the goals of blood clot prevention is to limit venous stasis as this is a significant risk factor for forming blood clots in the deep veins of the legs.[6] Venous stasis can occur during the long periods of not moving. Thrombosis prevention is also recommended during air travel.[7] Thrombosis prophylaxis is effective in preventing the formation of blood clots, their lodging in the veins, and their developing into thromboemboli that can travel through the circulatory system to cause blockage and subsequent tissue death in other organs.[1] Clarence Crafoord is credited with the first use of thrombosis prophylaxis in the 1930s.

  1. ^ a b c Brunner L (2010). Brunner & Suddarth's textbook of medical-surgical nursing. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. p. 876. ISBN 978-0781785907.
  2. ^ a b Matar CF, Kahale LA, Hakoum MB, Tsolakian IG, Etxeandia-Ikobaltzeta I, Yosuico VE, et al. (July 2018). "Anticoagulation for perioperative thromboprophylaxis in people with cancer". The Cochrane Database of Systematic Reviews. 2019 (7): CD009447. doi:10.1002/14651858.cd009447.pub3. PMC 6389341. PMID 29993117.
  3. ^ a b Kahale, Lara A.; Matar, Charbel F.; Hakoum, Maram B.; Tsolakian, Ibrahim G.; Yosuico, Victor Ed; Terrenato, Irene; Sperati, Francesca; Barba, Maddalena; Schünemann, Holger; Akl, Elie A. (December 8, 2021). "Anticoagulation for the initial treatment of venous thromboembolism in people with cancer". The Cochrane Database of Systematic Reviews. 2021 (12): CD006649. doi:10.1002/14651858.CD006649.pub8. ISSN 1469-493X. PMC 8653422. PMID 34878173.
  4. ^ a b Roderick P, Ferris G, Wilson K, Halls H, Jackson D, Collins R, Baigent C (December 2005). "Towards evidence-based guidelines for the prevention of venous thromboembolism: systematic reviews of mechanical methods, oral anticoagulation, dextran and regional anaesthesia as thromboprophylaxis". Health Technology Assessment. 9 (49): iii–iv, ix–x, 1–78. doi:10.3310/hta9490. PMID 16336844.
  5. ^ Grotta J (2016). Stroke : pathophysiology, diagnosis, and management. Philadelphia: Elsevier. pp. 953–62. ISBN 978-0323295444.
  6. ^ Martinelli I, Bucciarelli P, Mannucci PM (February 2010). "Thrombotic risk factors: basic pathophysiology". Critical Care Medicine. 38 (2 Suppl): S3-9. doi:10.1097/CCM.0b013e3181c9cbd9. PMID 20083911. S2CID 34486553.
  7. ^ Cite error: The named reference CDC2016 was invoked but never defined (see the help page).