Incidence of deep vein thrombosis following vascular surgery

Objective. The incidence of deep vein thrombosis (DVT) has been well documented in general and orthopaedic surgery but there have been few reports of the incidence of DVT following vascular surgery. Our aim was to perform a prospective study of the incidence of DVT in patients managed on the Vascular Unit at our institution. Experimental design. One hundred and forty two consecutive patients presenting for repair of abdominal aortic aneurysm, reconstruction of lower extremity arterial occlusive disease or amputation were studied. Venous duplex ultrasound examination was performed preoperatively and between day seven to 10 postoperatively. All patients received standard DVT prophylaxis of 5,000 units of unfractionated heparin subcutaneously three times daily and intraoperative sequential compression devices. Results. Fourteen patients (9.8%) were found to have postoperative DVT with one patient (0.7%) having a documented pulmonary embolism. The incidence of DVT following reconstructive surgery was 9.1% and 14.3% following amputation. Conclusions. In patients having vascular reconstructive surgery and, in particular, amputation, there is still a moderate risk of DVT despite the application of standard prophylactic measures. There may be a role for newer modalities of prophylaxis such as low molecular weight heparin especially in the higher risk amputation group.