A logical approach to surgical thromboprophylaxis

PURPOSE OF REVIEW: Venous thromboembolism is an important complication for patients undergoing surgery. Thromboprophylaxis reduces thromboembolic events. RECENT FINDINGS: In this review we discuss the evidence supporting the use of newer agents for thromboprophylaxis, rivaroxaban and dabigatran etexilate. We will also discuss current thromboprophylaxis options for patients undergoing bariatric surgery, including dose and duration of pharmacological prophylaxis and mechanical methods. The most recent The American College of Chest Physicians and American Academy of Orthopedic Surgeons guidelines are also reviewed. SUMMARY: Novel agents may modify our approach to thromboprophylaxis; although these agents offer reduced rates of venographic deep vein thrombosis, their impact on patient important outcomes (clinical deep vein thrombosis, pulmonary embolism and death) requires additional study.