Venous thromboembolism (VTE) is a well-known complication associated with surgical procedures. The implementation of thromboprophylaxis in this population has become a vital aspect of peri-operative care to decrease VTE-associated morbidity and mortality risk. However, data assessing the role of thromboprophylaxis for patients undergoing vascular surgery is sparse.
Assessing the role of thromboprophylaxis by low molecular weight heparin (LMWH) or unfractionated heparin (UFH) in vascular surgery.
We searched MEDLINE, Embase, and the Cochrane Collaboration Central Register of Controlled Trials from inception until December 2020, for randomized controlled trials (RCTs) assessing the role of thromboprophylaxis in vascular surgery.
Eight RCTs met inclusion criteria, including 3,130 patients, with a mean age of 55.35 years and 45% were females. Compared to placebo, anticoagulant use was associated with a reduction of deep venous thrombosis (DVT) (RR 0.34; 95% CI: 0.11-1.05; P=0.06: I=68%) and pulmonary embolism (PE) (RR 0.17; 95% CI: 0.02-1.22; P=0.08; I=41%), but this trend did not reach statistical significance. There was no difference for bleeding outcomes between anticoagulants and placebo (RR 0.90; 95% CI: 0.05-15.01; P=0.94; I=76%). There was no significant difference in outcomes when LMWH was compared directly to UFH. In a sensitivity analysis, anticoagulant use was associated with a significant reduction of DVT or PE in patients undergoing venous surgeries, but was not associated with a significant reduction of DVT or PE in patients undergoing arterial surgeries, although this analysis was limited by the small number of studies in each group.
Among patients undergoing vascular surgery, thromboprophylaxis with anticoagulants, showed a trend toward reduced incidence of VTE when compared to placebo, though not statistically significant. Bleeding outcomes were comparable between both treatment groups.

Copyright © 2021. Published by Elsevier Inc.

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