Abstract
Under the auspices of the Cardiovascular Disease Educational and Research Trust, European Venous Forum, North American Thrombosis Forum, International Union of Angiology and Union Internationale du Phlebologie.
This document is being published simultaneously in International Angiology and Clinical and Applied Thrombosis/Hemostasis with the full knowledge and consent of all authors.
Contents
Faculty 117
Corresponding faculty 117
Acknowledgements 117
Disclaimer 117
Glossary Introduction 118 The Problem and the Need for Prevention 121 General, Vascular, Bariatric, and Plastic Surgical Patients 122 Urologic Surgery 133 Gynecology and Obstetrics 135 Orthopedic Surgery and Trauma Elective Hip Replacement 142 Elective Knee Replacement 148 Hip Fracture Surgery 149 Knee Arthroscopy 150 Isolated Below Knee Injuries and Plaster Casts 150 Multiple Trauma 151 Elective Spine Surgery 152 Spinal Cord Injury 152 Burns 161 Neurosurgery 161 Medical Patients 163 Critical Care Medical Patients 171 Cancer Patients 172 Combined Modalities in Surgical Patients 177 Thrombophilia 177 Diagnosis and Anticoagulant Treatment 187 Thrombolytic Therapy 198 Inferior Vena Cava Filters 204 Surgical Thrombectomy 205 Treatment for Patients With Cancer 206 Heparin-Induced Thrombocytopenia 208 Superficial Thrombophlebitis 214 Prevention of Postthrombotic Syndrome 219 Periprocedural Management of Antithrombotic Therapy and Use of Bridging Anticoagulation 221 Cost-Effectiveness of Prevention 225 Key Questions to be Answered 229
Editorial Committee
Faculty
D. Bergqvist (Sweden)
J. Bonnar (Ireland)
J. A. Caprini (USA)
C. Carter (USA)
A. J. Comerota (USA)
J. Conard (France)
B. Eklof (Sweden)
I. Elalamy (France)
J. Fareed (USA)
J. Fletcher (Australia)
G. Gerotziafas (France)
G. Geroulakos (UK)
A. Giannoukas (Greece)
S. Z. Goldhaber (USA)
I. Greer (UK)
M. Griffin (UK)
R. Hull (USA)
A. K. Kakkar (UK)
S. Kakkos (Greece)
E. Kalodiki (UK)
M. R. Lassen (Denmark)
G. D. O. Lowe (UK)
A. Markel (Israel)
K. Myers (Australia)
A. Nicolaides (Cyprus)
P. Prandoni (Italy)
G. Raskob (USA)
M. Samama (France)
A. C. Spyropoulos (USA)
A. G. Turpie (Canada)
J. M. Walenga (USA)
D. Warwick (UK)
Corresponding Faculty
C. Allegra (Italy)
J. Arcelus (Spain)
N. Baekgaard (Denmark)
G. Belcaro (Italy)
H. Bjarnason (USA)
M. A. Cairols (Spain)
M. Catalano (Italy)
D. Christopoulos (Greece)
D. Clement (Belgium)
F. Corvalán (Chile)
E. Diamantopoulos (Greece)
J. Fernandes e Fernandes (Portugal)
C. Fisher (Australia)
A. Gasparis (USA)
H. Gibbs (Australia)
V. Hadjianastassiou (Cyprus)
K. Ivancev (UK)
C. P. Hsien (Thaiwan)
J. T. Hobbs (UK)
D. Hoppenstead (USA)
E. A. Hussein (Egypt)
O. Iqbal (USA)
K. Ivancev (Russia)
R. Kistner (USA)
T. K. Kim (Korea)
M. Kurtoglou (Turkey)
T Kölbel (Germany)
N Labropoulos (USA)
L. H. Lee (Singapore)
B. B. Lee (USA)
Y-J. Li (China)
N. C. Liew (Malaysia)
A. Llinas (Colombia)
M. Nakamura (Japan)
P. Neglen (Cyprus)
L. Norgren (Sweden)
H. Partsch (Austria)
N. Ramakrishnan (India)
G. Rao (USA)
J-B. Ricco (France)
N. Rich (USA)
P. Robless (Singapore)
W. Schobersberger (Austria)
M. Seed (UK)
S. Schellong (Germany)
A. Scuderi (Brazil)
R. Sexana (India)
E. Shaydakov (Russia)
A. Shevela (Russia)
R. Simkin (Argentina)
W. Toff (UK)
J. M. Trabal (Puerto Rico)
M. Vandendriessche (Belgium)
M. Veller (South Africa)
L. Villavincencio (USA)
R. Wahi (USA)
C. Wittens (The Netherlands)
R. Wong (Hong Kong)
Acknowledgments
The foundations for this International Consensus Statement were laid down by the European Consensus Statement on the Prevention of Venous Thromboembolism developed at Windsor (UK) in 1991 with support from the European Commission. 1 The European Consensus Statement was subsequently updated by an international faculty and was forged into “The International Consensus Statement” by extensive evaluation of the literature and debate during the International Union of Angiology (IUA) World Congress in London in April 1995. 2 The latter was updated at the IUA European Congress in Rhodes in May 1999 and was published in “International Angiology” in 2001. 3 Subsequent work by the editorial committee and faculty reconvened at Windsor (UK) in January 2005 produced the publication of 2006. 4 The current version has been updated by the faculty at a special meeting at the Royal Society of Medicine, London, UK in July 2011 and subsequent meetings in Chicago and Prague in July 2012.
We are grateful to the following companies for their educational grants towards the meetings of the faculty over the years 1991 to 2012: Abbott Laboratories, Advanced Technology Laboratories, AstraZeneca, Aventis, Bayer, Behringwerke/Hoechst AG, Boehringer Ingelheim Ltd, Braun, Covidien, Italfarmaco Spa, Kendall UK, Kendall HealthCare Inc, Knoll AG, Leo Pharmaceutical Products, Lilly Industries Ltd, Novamedix, Novartis, Novo Nordisk Pharmaceutical Ltd, N V Organon, Pentapharm, Pfizer, Pharmacia AB, Porton Products Ltd, Sanofi-Synthelabo, SanofiAventis, Tyco Healthcare, and Wyeth-Ayerst Laboratories.
Disclaimer
Due to the evolving field of medicine, new research may, in due course, modify the recommendations presented in this document. At the time of publication, every attempt has been made to ensure that the information provided is up to date and accurate. It is the responsibility of the treating physician to determine best treatment for the patient. The authors, committee members, editors, and publishers cannot be held responsible for any legal issues that may arise from citation of this statement or any updated versions printed or in electronic form.
Glossary
Antiplatelet Trialists Collaboration
combined oral contraceptives
chronic venous disease
chronic venous insufficiency
deep vein thrombosis
European Medicine Agency
foot impulse technology
fibrinogen uptake test
graduated elastic compression
heparin-induced thrombocytopenia
hormone replacement therapy
intermittent pneumatic compression
low-dose unfractionated heparin
low-molecular-weight heparin
odds ratio
pulmonary embolism
DVT in popliteal or more proximal veins
postthrombotic syndrome
quality of life
randomized controlled trial(s)
Royal College of Obstetricians and Gynaecologists
relative risk
total hip replacement
total knee replacement
unfractionated heparin
venous thromboembolism
World Health Organization
Distribution
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First published in 2013
© 2013 CDER Trust