Bariatric venous thromboembolism prophylaxis: an update on the literature.
Research article published in Expert review of hematology (2019)
Abstract
Introduction: Rates of obesity have been increasing worldwide and with the current situation obesity now represents an epidemic. Bariatric surgery is one the most effective ways to help reduce weight and sustain weight loss. Venous thromboembolism is a major cause of morbidity and mortality among bariatric surgery patients with no clearly established guidelines on prophylaxis. Areas covered: In this review the authors summarize clinical studies evaluating unfractionated heparin (UFH) and low molecular weight heparins (LMWH) in bariatric surgery patients. The authors present studies that assessed venous thromboembolic (VTE)-related risk stratification but also various dosing regimens of heparin products in this population of patients. Moreover, the authors will also present the feasibility of using direct oral anticoagulants (DOACs) for venous thromboembolism (VTE) prevention along with providing a summary of few current guidelines for VTE prevention in bariatric surgery patients. Expert opinion: Based on the data presented in this review, the authors conclude that LMWHs may be better options than UFH for VTE prophylaxis in bariatric surgery patients. We also conclude that risk stratifying bariatric patients may be a better approach when deciding on the best thromboprophylaxis modality, dose and duration.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Bariatric venous thromboembolism prophylaxis: an update on the literature.
Why This Matters for Hirudotherapy
This literature review on venous thromboembolism prophylaxis in bariatric surgery summarizes studies of unfractionated heparin, low-molecular-weight heparins, and direct oral anticoagulants, concluding that LMWHs may be preferable to UFH and that risk stratification should guide the choice of modality, dose, and duration. Its relevance to hirudotherapy is contextual rather than direct, situating leech-derived anticoagulation science within the broader landscape of systemic thromboprophylaxis where no leech product is used. The clear caveat is that this review addresses systemic anticoagulant prophylaxis in surgical patients and makes no mention of medicinal leeches or the leech secretome, so it informs general anticoagulation context only and carries no implication for leech therapy.
Citation
Bariatric venous thromboembolism prophylaxis: an update on the literature.
Hamadi et al. · Expert review of hematology, 2019
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