Slow femoral venous flow and venous thromboembolism following inguinal hernioplasty in patients without or with low molecular weight heparin prophylaxis

Lozano, Francisco; Sánchez-Fernández, Joel; González‐Porras, José Ramón; García-Alovio, J.; Santos, Javier; Mateos, Raquel; Alberca, Ignacio

doi:10.1007/s10029-015-1353-x

Cited by 4 publications

(5 citation statements)

References 33 publications

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“…A few previous studies have directly evaluated slow venous flow, and others have indirectly assessed patients at risk with presumed or confirmed venous stasis. Direct evaluations include work by Lozano et al, who assessed 218 patients in the immediate postoperative period after ipsilateral inguinal hernioplasty with mesh placement. That study demonstrated short‐term slowing of deep venous flow without an increased incidence of venous thromboembolism and near normalization of flow 7 days thereafter .…”

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confidence: 99%

“…Direct evaluations include work by Lozano et al, who assessed 218 patients in the immediate postoperative period after ipsilateral inguinal hernioplasty with mesh placement. That study demonstrated short‐term slowing of deep venous flow without an increased incidence of venous thromboembolism and near normalization of flow 7 days thereafter . An even shorter duration of slow venous flow was shown during intraperitoneal insufflation for laparoscopy, without evidence of an increased rate of DVT .…”

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confidence: 99%

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Qualitative Slow Blood Flow in Lower Extremity Deep Veins on Doppler Sonography: Quantitative Assessment and Preliminary Evaluation of Correlation With Subsequent Deep Venous Thrombosis Development in a Tertiary Care Oncology Center

Jensen

Chahin

Amin

et al. 2017

J of Ultrasound Medicine

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Objectives To determine whether qualitative sonographic appearance of slow deep venous flow in the lower extremities correlates with quantitative slow flow and an increased risk of deep venous thrombosis (DVT) in oncology patients. Materials and Methods In this IRB-approved retrospective study, we reviewed lower extremity venous Doppler ultrasounds for 975 consecutive patients: 482 with slow flow and 493 with normal flow. The subjective slow venous flow and absence of initial DVT were confirmed by two radiologists. Peak velocities were recorded at three levels. Each patient was followed for DVT development. The associations between DVT and the presence of slow venous flow were examined using Fisher exact test; the two-sample t test was used for peak velocity and DVT group comparisons. The optimal cutoff peak velocity to correlate with the radiologists’ perceived slow flow was determined by Youden’s index. Results DVT development in the slow flow group (21/482, 4.36%) was almost doubled compared to patients with normal flow (11/493, 2.23%) (P=0.0456). Measured peak venous velocities were lower in the slow venous flow group (P<0.001). Patients with subsequent DVT did not have a significant difference in venous velocities compared with their respective patient group. The sum of three venous level velocities resulted in the best cutoff to dichotomize groups into normal versus slow venous flow. Conclusions Qualitative slow venous flow in the lower extremities on Doppler ultrasound accurately correlates with quantitatively slower flow and preliminary evaluation suggests an associated mild, increased rate of subsequent DVT development in oncology patients.

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confidence: 99%

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confidence: 99%

Qualitative Slow Blood Flow in Lower Extremity Deep Veins on Doppler Sonography: Quantitative Assessment and Preliminary Evaluation of Correlation With Subsequent Deep Venous Thrombosis Development in a Tertiary Care Oncology Center

Jensen

Chahin

Amin

et al. 2017

J of Ultrasound Medicine

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“…By measuring the minimum blood velocity in the common femoral vein on the surgical side, flow velocity in the ipsilateral femoral vein was lower than that of the contralateral femoral vein (20.9 cm/s vs. 24.0 cm/s; p < 0.001) 9 . The diameter of the ipsilateral common femoral vein was larger than that on the contralateral side (p < 0.001), although this was found only with left inguinal hernia operation 9 . But in other publications such an observation has not been confirmed yet.…”

Section: Discussionmentioning

confidence: 92%

“…In a prospective study published in 2015, in the immediate postoperative period, inguinal hernioplasty with mesh induces a temporarily slow venous flow in the ipsilateral CFV. However, this does not lead to an increase in the incidence of VTE 9 . In addition, to avoid postoperative hematoma or seroma, some doctors use postoperative inguinal compression, which may also lead to VTE clinically.…”

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confidence: 97%

Current prevalence of perioperative early venous thromboembolism and risk factors in Chinese adult patients with inguinal hernia (CHAT-1)

Wang

Chen

et al. 2020

Sci Rep

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Venous thromboembolism (VTE) is an important postoperative complication. We investigated and analyzed the current inguinal hernia treatment methods and occurrence of early postoperative VTE in Chinese adults. This study involved data for patients with inguinal hernia hospitalized in 58 general hospitals in mainland China from January 1st, 2017 to December 31st, 2017. Data were retrospectively analyzed using a questionnaire. After data inputting and cleaning, we stratified and statistically analyzed patients' data using Caprini scores to create a high-, middle-, and low-risk group. A total of 14,322 patients with inguinal hernia were admitted to the 58 participating hospitals. After data collation and cleaning, 13,886 patients (97.0%) met our inclusion and exclusion criteria. The percentages of laparoscopic surgery and open surgery were 51.2% and 48.8%, respectively. 16 VTEs occurred during the hospitalization, accounting for 0.1% of all adverse events (95% confidence interval (CI) 0.11-0.13). The incidence of VTE was 0.2% (95% CI 0.18-0.2) in the high-risk group and 0.02% (95% CI 0.01-0.03) in the middle-risk group, based on Caprini scoring, with a significant difference (p < 0.0001). No VTE occurred in the low-risk group. Only 3,250 (23.4%) patients underwent Caprini risk assessment regarding treatment, with 13.2% receiving any prevention and only 1.2% receiving appropriate prevention. The treatment of inguinal hernia in Chinese adults has progressed somewhat; however, the evaluation and prevention of perioperative VTE was seriously neglected, in our study, and the incidence of postoperative VTE was underestimated postoperatively. Risk factors continue to be inadequately considered. With developments in surgical techniques and materials, satisfactory results have been achieved in the diagnosis and treatment of inguinal hernia, worldwide 1. Regarding the various aspects of the diagnosis and treatment of adult inguinal hernia, the HerniaSurge Group released the latest version of adult inguinal hernia management guidelines in 2018 2. Along with the guidelines from several other international hernia associations, and other associations, the HerniaSurge Group guidelines discuss the problems related to the diagnosis and treatment of inguinal hernia, in different perspectives, among which, cited references included studies performed by Chinese

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“…There are a small number of studies of vein flow velocity and its role in postoperative dvt. Some studies were conducted in laparoscopic, gastric bypass and inguinal hernioplasty patients, where vein flow velocity was followed up postoperatively as a predictor factor of postoperative dvt, without assessing preoperative vein flow velocity [10][11][12] . during thA, the lower limb is placed in many different positions, of which in some positions such as hyperflexion the veins can be compressed and blood flow velocity decreased, leading to vein stasis, possible thrombus formation, and consequent dvt and vte [13][14][15] .…”

Section: Introductionmentioning

confidence: 99%

Preoperative Femoral Vein Velocity in Maximal Flexion Is a Predictor of Deep Vein Thrombosis in Patients Undergoing Total Hip Arthroplasty

Hadžimehmedagić

Rovčanin²,

Vranić

et al. 2020

ACC

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The aim of the study was to investigate if preoperative blood flow velocity in femoral vein in different positions of the hip during total hip arthroplasty (thA) is a predictor of postoperative deep vein thrombosis (dvt). in patients undergoing thA, blood flow velocity and diameter of proximal femoral vein on thA side were measured preoperatively in four flexion positions of the hip. After thA, patients were followed up for 42 days for dvt occurrence, and clinical features of patients with and without postoperative dvt were compared. The mean blood flow velocity in maximal flexion (90º+) preoperatively was significantly lower in patients with postoperative dvt (19/103) compared to patients without it (8.4±2 cm/s vs. 10.6±2.3 cm/s; p<0.001). using the receiver operating characteristic curve analysis, the cutoff value for blood flow velocity during maximal flexion was 8.24 cm/s. in addition, anesthesia duration, duration of surgical position of the patient, body mass index, amount of blood transfused after surgery, and clinical signs of dvt were markedly different between patients with and those without postoperative dvt. blood flow velocity in femoral vein in maximal flexion of the hip (90º+) measured prior to thA is an independent predictor of postoperative dvt.

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Slow femoral venous flow and venous thromboembolism following inguinal hernioplasty in patients without or with low molecular weight heparin prophylaxis

Abstract: In the immediate postoperative period, inguinal hernioplasty with mesh induces a temporarily slow venous flow in the ipsilateral CFV. However, this does not lead to an increase in the incidence of VTE.

Cited by 4 publications

References 33 publications

Qualitative Slow Blood Flow in Lower Extremity Deep Veins on Doppler Sonography: Quantitative Assessment and Preliminary Evaluation of Correlation With Subsequent Deep Venous Thrombosis Development in a Tertiary Care Oncology Center

Qualitative Slow Blood Flow in Lower Extremity Deep Veins on Doppler Sonography: Quantitative Assessment and Preliminary Evaluation of Correlation With Subsequent Deep Venous Thrombosis Development in a Tertiary Care Oncology Center

Current prevalence of perioperative early venous thromboembolism and risk factors in Chinese adult patients with inguinal hernia (CHAT-1)

Preoperative Femoral Vein Velocity in Maximal Flexion Is a Predictor of Deep Vein Thrombosis in Patients Undergoing Total Hip Arthroplasty

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