PMID- 15966091
OWN - NLM
STAT- MEDLINE
DCOM- 20050725
LR  - 20220331
IS  - 1078-5884 (Print)
IS  - 1078-5884 (Linking)
VI  - 29
IP  - 5
DP  - 2005 May
TI  - Antithrombotic strategies in vascular surgery: evidence and practice.
PG  - 516-21
AB  - BACKGROUND: The aim of this study was to evaluate the current practice of peri 
      and postoperative antithrombotic therapy in vascular surgery in Austria and to 
      compare this with the results of randomised prospective clinical trials. METHODS: 
      A questionnaire assessing intra, postoperative and long-term antithrombotic 
      treatment in 13 different surgical procedures (three supra-aortic, three 
      aorto-iliac reconstructions and seven inguinal and infra-inguinal arterial 
      reconstructions) was sent to all 22 institutions training vascular surgical 
      fellows in Austria. RESULTS: Intraoperative antithrombotic therapy was quite 
      consistently performed with unfractionated heparin (UFH) with or without 
      acetylsalicylic acid (ASA). Early and long-term postoperative therapy differed 
      considerably. Most centres used low molecular weight heparin (LMWH) for early 
      postoperative therapy after vascular reconstructions, in > 75% combined with ASA 
      and/or clopidogrel. Long-term therapy consisted of antiplatelet agents in all 
      centres. Vascular grafts were anticoagulated with UFH in 25% of the centres in 
      the early postoperative period, the remaining institutions used LMWH +/- 
      antiplatelet agents. For long-term antithrombotic therapy cumarins were used in 
      75% of the centres, predominantly for venous grafts. Distal prosthetic grafts 
      were mainly treated with antiplatelet agents. Intraoperative antithrombotic 
      therapy was in accordance to present guidelines, postoperative antithrombotic 
      therapy, however, differed considerably between the participating institutions 
      and the results of available controlled studies. CONCLUSION: Optimal 
      antithrombotic strategies during and after vascular surgery are still under 
      debate, and current practice often differs from available evidence. Vascular 
      surgical societies should be encouraged to define recommendations on antiplatelet 
      therapy and anticoagulation for different vascular interventions.
FAU - Assadian, A
AU  - Assadian A
AD  - Department of General and Vascular Surgery, Wilhelminenspital Vienna, Vienna, 
      Austria. afshin_assadian@yahoo.de
FAU - Senekowitsch, C
AU  - Senekowitsch C
FAU - Assadian, O
AU  - Assadian O
FAU - Eidher, U
AU  - Eidher U
FAU - Hagmuller, G W
AU  - Hagmuller GW
FAU - Knobl, P
AU  - Knobl P
LA  - eng
PT  - Journal Article
PL  - England
TA  - Eur J Vasc Endovasc Surg
JT  - European journal of vascular and endovascular surgery : the official journal of 
      the European Society for Vascular Surgery
JID - 9512728
RN  - 0 (Fibrinolytic Agents)
SB  - IM
MH  - Austria
MH  - Fibrinolytic Agents/*therapeutic use
MH  - Humans
MH  - Perioperative Care
MH  - Practice Patterns, Physicians'
MH  - Surveys and Questionnaires
MH  - *Vascular Surgical Procedures
EDAT- 2005/06/21 09:00
MHDA- 2005/07/26 09:00
CRDT- 2005/06/21 09:00
PHST- 2005/06/21 09:00 [pubmed]
PHST- 2005/07/26 09:00 [medline]
PHST- 2005/06/21 09:00 [entrez]
AID - S1078-5884(05)00050-X [pii]
AID - 10.1016/j.ejvs.2005.01.021 [doi]
PST - ppublish
SO  - Eur J Vasc Endovasc Surg. 2005 May;29(5):516-21. doi: 10.1016/j.ejvs.2005.01.021.