Prevention of deep venous thrombosis

  • Paolo Prandoni


The increasing widespread use of objective methods to detect deep venous thrombosis has made possible to identify various groups of patients at different risk for developing this pathological condition. The present review provides a tentative scheme, based upon analysis of the most rigorous literature studies, for selection of the available methods of prevention according to the different risk levels.


Deep venous thrombosis Pharmacological treatment Prevention Risk factors Surgery 


  1. 1.
    Allan A., Williams J. T., Bolton J. P., Le Quesne L. P.: The use of graduate compression stockings in the prevention of deep vein thrombosis — Brit. J. Surg.70, 172, 1983.PubMedCrossRefGoogle Scholar
  2. 2.
    Belch J. J., Lowe G. D. O., Ward A. G., Forbes C. D., Prentice C. R. M.: Prevention of deep vein thrombosis in medical patients by low-dose heparin — Scot. med. J.26, 115, 1981.PubMedGoogle Scholar
  3. 3.
    Bergquist D., Burmark U. S., Frisell J., Hallböök T., Lindblad B., Risberg B., Törngren S., Wallin G.: Prospective double-blind comparison between fragmin and conventional low-dose heparin: thromboprophylactic effect and bleeding complications — Haemostasis16 (Suppl. 2), 11, 1986.Google Scholar
  4. 4.
    Caprini J. A., Chucker J. L., Zuckerman L., Vagher J. P., Frank C. A., Cullen J. E.: Thrombosis prophylaxis using external compression — Surg. Gynecol. Obstetr.156, 599, 1983.Google Scholar
  5. 5.
    Consensus Conference: Prevention of venous thrombosis and pulmonary embolism — J. Amer. med. Ass.256, 744, 1986.CrossRefGoogle Scholar
  6. 6.
    Dahan R., Houlbert D., Caulin C., Cuzin E., Viltart C., Woler M., Segrestaa J. M.: Prevention of deep vein thrombosis in elderly medical in-patients by a low molecular weight heparin: a randomized double-blind trial — Haemostasis16, 159, 1986.PubMedGoogle Scholar
  7. 7.
    Emerson P. A., Marks P.: Preventing thromboembolism after myocardial infarction: effect of low-dose heparin or smoking — Brit. med. J.i, 18, 1977.CrossRefGoogle Scholar
  8. 8.
    Francis C. W., Marder V. J., McCollister E. C., Yaukoolbodi S.: Two-step warfarin therapy. Prevention of postoperative venous thrombosis without excessive bleeding — J. Amer. med. Ass.249, 374, 1983.CrossRefGoogle Scholar
  9. 9.
    Gallus A. S., Hirsh J., Tuttle R. J., Trebilcock R., O’Brien S. E., Caroll J. J., Minden J. H., Hudecki S. M.: Small subcutaneous doses of heparin in prevention of venous thrombosis — New Engl. J. Med.288, 545, 1973.PubMedGoogle Scholar
  10. 10.
    Gallus A., Raman K., Darby T.: Venous thrombosis after elective hip replacement. The influence of preventive intermittent calf compression and of surgical technique — Brit. J. Surg.70, 17, 1983.PubMedCrossRefGoogle Scholar
  11. 11.
    Gruber U. F.: Prevention of fatal postoperative pulmonary embolism by heparin-dihydroergotamine or dextran 70 — Brit. J. Surg.69 (Suppl.), 54, 1982.CrossRefGoogle Scholar
  12. 12.
    Gruber U. F., Saldeen T., Brokop T., Eklof B., Eriksson I., Goldle I., Gran L., Hohl M., Johnsson T., Kristersson S., Ljungstrom K. G., Lund T., Maartman M. H., Svensjo E., Thomson D., Torhorst J., Trippestad A., Ulstein M.: Incidence of fatal postoperative pulmonary embolism after prophylaxis with dextran 70 and low-dose heparin — Brit. med. J.280, 69, 1980.PubMedGoogle Scholar
  13. 13.
    Halkin H., Goldberg J., Modan M., Modan B.: Reduction of mortality in general in-patients by low-dose heparin prophylaxis — Ann. intern. Med.96, 561, 1982.PubMedGoogle Scholar
  14. 14.
    Harris W. H., Athanasoulis C. A., Waltman A. C., Salzman E. W.: Prophylaxis of deep-vein thrombosis after total hip replacement — J. Bone Jt Surg.67A, 57, 1985.Google Scholar
  15. 15.
    Harris W. H., Salzman E. W., Athanasoulis C. A., Waltman A. C., De Sanctis R. W.: Aspirin prophylaxis of venous thromboembolism after total hip replacement — New Engl. J. Med.297, 1246, 1977.PubMedGoogle Scholar
  16. 16.
    Hirsh J.: Prophylaxis of venous thromboembolism — Mod. Conc. cardiovasc. Dis.53, 25, 1984.Google Scholar
  17. 17.
    Hull R. D., Delmore T. J., Hirsh J., Gent M., Armstrong P., Lofthouse R., MacMillan A., Blackstone I., Reed-Davis R., Detwiler R. C.: Effectiveness of intermittent pulsatile elastic stockings for the prevention of calf and thigh vein thrombosis in patients undergoing elective knee surgery — Thrombos. Res.16, 37, 1979.CrossRefGoogle Scholar
  18. 18.
    Hull R. D., Raskob G. E., Hirsh J., Sackett D. L.: A cost-effectiveness analysis of alternative approaches for long-term treatment of proximal venous thrombosis — J. Amer. med. Ass.252, 235, 1984.CrossRefGoogle Scholar
  19. 19.
    Inada K., Shirai N., Hayashi M., Matsumoto K., Hirose M.: Postoperative deep venous thrombosis in Japan. Incidence and prophylaxis — Amer. J. Surg.145, 775, 1983.PubMedCrossRefGoogle Scholar
  20. 20.
    International Multicenter Trial: Prevention of fatal postoperative pulmonary embolism by low doses of heparin — Lancetii, 45, 1975.Google Scholar
  21. 21.
    Kakkar V. V., Fok P. J., Murray W. J. G., Paes T., Merenstein D., Dodds R., Farrell R., Crellin R. Q., Thomas E. M., Morley T. R., Price A. J.: Heparin and dihydroergotamine prophylaxis against thromboembolism after hip arthroplasty — J. Bone Jt Surg.67B, 538, 1985.Google Scholar
  22. 22.
    Kakkar V. V., Murray W. J. G.: Efficacy and safety of low-molecular-weight heparin (CY216) in preventing postoperative venous thromboembolism: a cooperative study — Brit. J. Surg.72, 786, 1985.PubMedCrossRefGoogle Scholar
  23. 23.
    Koller M., Schoch U., Buchmann P., Largiader F., von Felten A., Frick P. G.: Low molecular weight heparin (Kabi 2165) as thromboprophylaxis in elective visceral surgery. A randomized, double-blind study versus unfractionated heparin — Thrombos. Haemost.56, 243, 1986.Google Scholar
  24. 24.
    Leyvraz P. F., Richard J., Bachmann F., van Melle G., Treyvaud J. M., Livio J. J., Candardjis G.: Adjusted-versus fixed-dose subcutaneous heparin in the prevention of deep vein thrombosis after total hip replacement — New Engl. J. Med.309, 954, 1983.PubMedGoogle Scholar
  25. 25.
    McCarthy S. T., Turner J. J., Robertson D., Hawkey C. J., Macey D. J.: Low-dose heparin as a prophylaxis against deep vein thrombosis after acute stroke — Lancetii, 800, 1977.CrossRefGoogle Scholar
  26. 26.
    Multicenter Trial Committee: Dihydroergotamine-heparin prophylaxis of postoperative deep-vein thrombosis — J. Amer. med. Ass.251, 2960, 1984.CrossRefGoogle Scholar
  27. 27.
    Neri Serneri G. G., Gensini G. F., Fortini A.: Progressi e nuovi indirizzi nell’impiego terapeutico dell’eparina — G. ital. Cardiol.15, 98, 1985.PubMedGoogle Scholar
  28. 28.
    Nicolaides A. N., Miles C., Hoare M., Jury P., Helmis E., Venniker R.: Intermittent sequential pneumatic compression of the legs and thromboembolism-deterrent stockings in the prevention of postoperative deep venous thrombosis — Surgery94, 21, 1982.Google Scholar
  29. 29.
    Prandoni P., Menozzi L., Zambon G., Breda A., Ruol A.: Moderni aspetti di fisiopatologia, clinica, terapia e prevenzione della tromboembolia polmonare — Basi raz. Ter.15, 207, 1985.Google Scholar
  30. 30.
    Roberts V. C., Cotton L. T.: Prevention of postoperative deep vein thrombosis in patients with malignant disease — Brit. med. J.i, 358, 1974.Google Scholar
  31. 31.
    Sasahara A. A., Koppenhagen K., Häring R., Welzel D., Wolf H.: Low molecular weight heparin plus dihydroergotamine for prophylaxis of postoperative deep vein thrombosis — Brit. J. Surg.73, 697, 1986.PubMedCrossRefGoogle Scholar
  32. 32.
    Sautter R. D., Koch E. L., Myers W. O., Ray J. R., Mazza J. J., Larson D. E., Chen H. M., Milbauer J. P., Treuhaft P. S., Plotka E. D., Wenzel F. J., Nycz G., Pierce W. E.: Aspirinsulfinpyrazone in prophylaxis of deep venous thrombosis in total hip replacement — J. Amer. med. Ass.250, 2649, 1983.CrossRefGoogle Scholar
  33. 33.
    Skillman J. J., Collins R. E., Coe N. P., Goldstein B. S., Shapiro R. M., Zervas N. T., Bettman M. A., Salzman E. W.: Prevention of deep vein thrombosis in neurosurgical patients: a controlled randomized trial of external pneumatic compression boots — Surgery83, 354, 1978.PubMedGoogle Scholar
  34. 34.
    Turpie A. G. G., Gallus A., Beattle W. S., Hirsh J.: Prevention of venous thrombosis in patients with intracranial disease by intermittent pneumatic compression of the calf — Neurology (Minneap.)27, 435, 1977.Google Scholar
  35. 35.
    Turpie A. G. G., Levine M. N., Hirsh J., Carter C. J., Jay R. M., Powers P. J., Andrew M., Hull R., Gent M.: A randomized controlled trial of low-molecular-weight heparin (enoxaparin) to prevent deep-vein thrombosis in patients undergoing elective hip surgery — New Engl. J. Med.315, 925, 1986.PubMedGoogle Scholar
  36. 36.
    Warlow C., Beattie A. G., Terry G., Ogston D., Kenmure A. C. F., Douglas A. D.: A double-blind trial of low doses of subcutaneous heparin in the prevention of deep vein thrombosis after myocardial infarction — Lancetii, 934, 1973.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 1987

Authors and Affiliations

  • Paolo Prandoni
    • 1
  1. 1.Istituto di Medicina ClinicaUniversità degli Studi di PadovaPadovaItalia

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