RESUMO
A 2008 survey of American Association of Hip and Knee Surgeons membership explored current venous thromboembolism (VTE) protocols for lower-extremity total joint surgery. Fifty-three percent reported a change in VTE-related practices in the last 5 years. More than 70% reported that their primary hospital now mandates VTE prophylaxis. Although 74% of their primary hospitals recognized the American College of Chest Physicians guidelines, 68% of surgeons felt the American Academy of Orthopaedic Surgeons guidelines were more relevant to their practice. Respondents believe low molecular weight heparin to be the most efficacious but aspirin to be the easiest to use and has the lowest risks of bleeding and wound drainage. Warfarin was the most used in hospital prophylaxis, and 90% of respondents targeted an international normalized ratio of 1.6 to 2.5. Practice patterns continue to evolve, and there remains no consensus on specific treatment protocols or preferences.
Assuntos
Artroplastia de Quadril/efeitos adversos , Artroplastia do Joelho/efeitos adversos , Ortopedia , Tromboembolia Venosa/prevenção & controle , Anticoagulantes/uso terapêutico , Coleta de Dados , Humanos , Cuidados Pós-Operatórios , Cuidados Pré-Operatórios , Medição de Risco , Sociedades Médicas , Estados Unidos , Tromboembolia Venosa/diagnóstico , Tromboembolia Venosa/etiologia , Tromboembolia Venosa/terapiaRESUMO
Coronary artery dissection is a well-described but rare complication of diagnostic angiography. With increased numbers of patients undergoing coronary artery bypass grafting, the number of patients undergoing repeat angiography for chest pain should likewise increase. The authors report two cases of catheter-induced left internal mammary (LIMA) dissection and review the existing literature.
