cardiovascular disorders
Deep Venous Thrombosis (DVT)
Prevention of Deep Venous Thrombosis
It is preferable and safer to prevent DVT than to treat it, particularly in patients who are at high risk. The following modalities are used (for a more complete discussion, see Deep Venous Thrombosis (DVT) Prevention ). Prevention of immobility Prophylactic anticoagulation (eg, low molecular weightheparin,fondaparinux, adjusted-dosewarfarin, direct oral anticoagulant) Intermittent pneumatic compression Patients who should not receive anticoagulants may benefit from intermittent pneumatic compression devices, elastic stockings, or both. Inferior vena cava (IVC) filter do not prevent DVT but are sometimes placed in an attempt to prevent PE. An IVC filter may help prevent PE in patients with lower extremity DVT who have contraindications to anticoagulant therapy or in patients with recurrent DVT (or emboli) despite adequate anticoagulation. IVC filters are also sometimes used for the primary prevention of PE after certain types of surgery or in patients with multiple severe injuries; however, their use is not routinely recommended for these indications given the lack of evidence of efficacy ( 1.Ho KM, Rao S, Honeybul S, et al. A Multicenter Trial of Vena Cava Filters in Severely Injured Patients.N Engl J Med2019;381(4):328-337. doi:10.1056/NEJMoa1806515 