Risk Management: Strategy for Prevention of Thromboembolism Resulting from Varicose Veins

概要

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A risk management strategy to prevent thromboembolism is described. 1. Some patients with thrombi in varicose veins show defects on lung perfusion scintigrams and a case of venous thromboembolism (VTE) was encountered after stripping of varicose veins. 2. Emergent surgical treatment is now selected when patients suffer from thrombi adjacent to a deep vein and spinal anesthesia has been changed to general anesthesia for early ambulation. Furthermore, elastic stockings are now used instead of elastic bandages for hemostasis. 3. In order to prevent postoperative VTE, the VTE Working Group prepared a checklist of vascular disorders for all patients scheduled for surgical treatment in all departments. High risk patients visit the vascular division, and the appropriate preventive measures are discussed by our staff. 4. The Anticoagulant Working Group is evaluating the use of medicines and dietary supplements of all patients scheduled for surgery. As a general rule, anticoagulants should be stopped before the operation; however, in some patients, heparin is used for the prevention of cerebral thromboembolism. Stripping of varicose veins can be performed safely without stopping anticoagulants. In conclusion, the significance of thromboembolism should be recognized by all hospital staff and systematic steps should be taken to prevent its occurrence.
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