Ribeiro Alcides José Araújo, Mendes-Pinto Daniel, Erzinger Fabiano Luiz, Fiorelli Rossano Kepler Alvim, Fiorelli Stênio Karlos Alvim, Ribeiro Andrea Campos de Oliveira, Marques Marcos Arêas
Hospital de Base do Distrito Federal, Brasília, DF, Brasil.
Hospital Felício Rocho, Belo Horizonte, MG, Brasil.
J Vasc Bras. 2022 May 16;21:e20210172. doi: 10.1590/1677-5449.202101721. eCollection 2022.
Despite all the investment in primary venous thromboembolism (VTE) prophylaxis for surgical patients in recent years, there are still no specific guidelines for those who undergo procedures to treat lower limb varicose veins.
To evaluate the profile of VTE prophylaxis practices among Brazilian vascular surgeons conducting lower limb varicose vein procedures.
Survey design, sending an electronic questionnaire to Brazilian vascular surgeons. Respondents were divided between those who perform saphenous vein treatment with conventional surgery and those who perform thermoablation for the purpose of comparison between groups.
Of 765 respondents, 405 (53%) treat saphenous veins with conventional surgery for, 44 (6%) with foam, and 199 (26%) with thermoablation (endolaser or radiofrequency). Surgeons who perform thermoablation prescribed more pharmacoprophylaxis after varicose vein surgery than those who perform conventional surgery (67/199, 34% vs. 112/405, 28%; p = 0.002). The thermoablation group stratifies patients for thromboembolism risk more frequently than the conventional surgery group (102/199, 51% vs. 179/405, 44%; p = 0.004). Both groups use enoxaparin as the most frequent drug for prophylaxis, but the thermoablation group uses proportionally more direct oral anticoagulants than the conventional surgery group (26% vs. 10%, p<0.001).
Brazilian vascular surgeons who perform saphenous vein treatment by thermoablation prescribe pharmacoprophylaxis more frequently and for a longer period than those who use conventional surgery.
尽管近年来对外科手术患者的原发性静脉血栓栓塞症（VTE）预防投入了大量资源，但对于接受下肢静脉曲张治疗手术的患者，仍没有具体的指南。
评估巴西进行下肢静脉曲张手术的血管外科医生的VTE预防措施情况。
采用调查设计，向巴西血管外科医生发送电子问卷。为了进行组间比较，将受访者分为采用传统手术治疗大隐静脉的医生和采用热消融治疗的医生。
在765名受访者中，405名（53%）采用传统手术治疗大隐静脉，44名（6%）采用泡沫硬化剂治疗，199名（26%）采用热消融（腔内激光或射频）治疗。与采用传统手术的医生相比，采用热消融治疗的医生在静脉曲张手术后开具药物预防的比例更高（67/199，34%对112/405，28%；p = 0.002）。热消融组比传统手术组更频繁地对患者进行血栓栓塞风险分层（102/199，51%对179/405，44%；p = 0.004）。两组均最常使用依诺肝素进行预防，但热消融组使用直接口服抗凝剂的比例高于传统手术组（26%对10%，p<0.001）。
与采用传统手术的巴西血管外科医生相比，采用热消融治疗大隐静脉的医生开具药物预防的频率更高，且时间更长。
