PMID- 23337406
OWN - NLM
STAT- MEDLINE
DCOM- 20150811
LR  - 20191210
IS  - 1827-191X (Electronic)
IS  - 0021-9509 (Linking)
VI  - 56
IP  - 1
DP  - 2015 Feb
TI  - Perioperative prophylactic antithrombotic strategies in vascular surgery: current 
      practice in the Netherlands.
PG  - 119-25
AB  - AIM: The aim of this study was to evaluate the current practice of the use of 
      perioperative antithrombotic drugs to prevent arterial thrombo-embolic 
      complications during arterial vascular surgery by Dutch vascular surgeons. Aim 
      was also to compare the results with the literature and to evaluate the effect of 
      guidelines. METHODS: A comprehensive questionnaire was sent to all Dutch vascular 
      surgeons performing arterial reconstructive surgery. RESULTS: The response rate 
      was 84%. Acetylsalicylic acid (ASA) was continued perioperatively by most 
      surgeons (91%). Clopidogrel was discontinued by the majority of respondents 
      (65%). During operation 97% of surgeons administered unfractionated heparin (UFH) 
      before arterial clamping. A minority (11%) measures peroperatively anticoagulant 
      activity in patients' blood. After infrainguinal venous bypass most surgeons 
      (81%) preferred monotherapy with vitamin K antagonists (VKA), in agreement with 
      the Dutch guideline in this respect. Before the introduction of the guideline in 
      2005, a survey was performed in 2004. Results of our 2011 survey showed more 
      respondents (6% to 11%) prescribed ASA or VKA according to these guidelines. 
      CONCLUSION: This survey showed a recognizable pattern of variation for 
      perioperative arterial thrombosis prophylaxis amongst Dutch vascular surgeons, in 
      agreement with reports from other countries over the past 20 years. Although a 
      higher percentage of surgeons complied in 2011 with existing guidelines than in 
      2004, guidelines were not completely met. Possibly because current guidelines are 
      not fully supported by evidence and do not cover all aspects of perioperative 
      arterial thrombosis prophylaxis. Clearly there is need for (more) convincing data 
      based on RCT's concerning the various aspects of perioperative arterial 
      thrombosis prophylaxis.
FAU - Wiersema, A
AU  - Wiersema A
AD  - Department of Surgery, Westfriesgasthuis Hoorn, The Netherlands - 
      arno@wiersema.nu.
FAU - Bruijninckx, C
AU  - Bruijninckx C
FAU - Reijnen, M
AU  - Reijnen M
FAU - Vos, J
AU  - Vos J
FAU - Van Delden, O
AU  - Van Delden O
FAU - Vahl, A
AU  - Vahl A
FAU - Zeebregts, C
AU  - Zeebregts C
FAU - Moll, F
AU  - Moll F
LA  - eng
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
DEP - 20130122
PL  - Italy
TA  - J Cardiovasc Surg (Torino)
JT  - The Journal of cardiovascular surgery
JID - 0066127
RN  - 0 (Anticoagulants)
RN  - 0 (Fibrinolytic Agents)
SB  - IM
MH  - Anticoagulants/*administration & dosage/adverse effects
MH  - Drug Administration Schedule
MH  - Drug Therapy, Combination
MH  - Fibrinolytic Agents/*administration & dosage/adverse effects
MH  - Guideline Adherence/trends
MH  - Health Care Surveys
MH  - Humans
MH  - Netherlands
MH  - Perioperative Care
MH  - Practice Guidelines as Topic
MH  - Practice Patterns, Physicians'/*trends
MH  - Surveys and Questionnaires
MH  - Thrombosis/etiology/*prevention & control
MH  - Time Factors
MH  - Treatment Outcome
MH  - Vascular Surgical Procedures/*adverse effects
EDAT- 2013/01/23 06:00
MHDA- 2015/08/12 06:00
CRDT- 2013/01/23 06:00
PHST- 2013/01/23 06:00 [entrez]
PHST- 2013/01/23 06:00 [pubmed]
PHST- 2015/08/12 06:00 [medline]
AID - R37137162 [pii]
PST - ppublish
SO  - J Cardiovasc Surg (Torino). 2015 Feb;56(1):119-25. Epub 2013 Jan 22.