Thrombophilia surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Asiri Ediriwickrema, M.D., M.H.S. [2] Jaspinder Kaur, MBBS[3]

Overview

Surgery is not required for treatment for thrombophilia. IVC filter placement may be indicated if the patient has contraindications to or complications from anticoagulation, recurrent thrombosis on anticoagulation, or failure to acheive therapeutic anticoagulation levels.[1]

Surgery

  • Surgery is usually not required for the treatment for thrombophilia. However, an endovascular treatment is used in some facilities to manage thrombosis apart from pharmacological management and considered more successful if the thrombus is truly acute with the clot formation two weeks before the presentation.
  • Different endovascular methods are as follows: [2]
    • Catheter-directed thrombolysis
    • Percutaneous aspiration thrombectomy
    • Venous balloon dilatation
    • Pharmacomechanical catheter-directed thrombolysis
    • IVC filter placement
  • Inferior vena cava (IVC) filters: Its use remains controversial in the acute setting and should be considered in selected cases as they carry their own risk of potential complications and can serve as a nidus for thrombus formation. IVC filter placement may be indicated in certain scenarios:[3]
    • Contraindications to or complications from anticoagulation
    • Recurrent thrombosis on anticoagulation, or failure to acheive therapeutic anticoagulation levels
    • Severe active bleeding

References

  1. Inferior Vena Cava Filters. Medscape (2015). URL Accessed on July 17, 2016
  2. Goktay AY, Senturk C (2017). "Endovascular Treatment of Thrombosis and Embolism". Adv Exp Med Biol. 906: 195–213. doi:10.1007/5584_2016_116. PMID 27664152.
  3. "Thrombosis - StatPearls - NCBI Bookshelf".

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