Anti-clotting therapy may be used too often following orthopaedic surgery... (g events they can pose a unique dilemma ...)

Anti-clotting therapy may be used too often following orthopaedic surgery or trauma

Date:8/31/2012

g events, they can pose a unique dilemma which can be very challenging to treat," Dr. Tornetta noted.

In addition to the increased PE risks associated with some orthopaedic procedures or injuries, other factors also can increase a patient's chances of developing one of these conditions, including:

Older age
Use of oral contraceptives
Having a personal or family history of PE
Undergoing extensive or prolonged surgical procedures
Undergoing a lengthy period of immobilization following surgery or trauma

Identifying Clots and Diagnosing PE

Many patients with PE have specific symptoms, including:

Sudden shortness of breath
Sudden onset of chest pain
Localized chest pain with coughing
Rapid heart beat

However, many orthopaedic patients with potentially dangerous clots do not have symptoms. For these patients, other methods of diagnosis must be used, including blood tests and imaging studies. The most common and popular imaging test is the computerized tomography pulmonary angiogram (CTPA), a very sensitive test that is capable of identifying potentially serious clots that could otherwise go undetected. But, because the CTPA is so sensitive, it may also identify much smaller clots which could resolve without use of anticoagulants.

"While it's clear that the use of blood thinners is of paramount importance in treating clinically relevant PE to prevent death, it is also becoming clear that many of these patients may not need the same aggressive level of these medications, which could substantially reduce their risks of bleeding problems," Dr. Tornetta said.

Different Approach

While there is no consensus regarding optimal PE treatment, Dr. Tornetta said the results of the recent studies indicate that physicians who treat orthopaedic surgery and trauma patients may need to use broader criteria when screening for potent
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Contact: Kayee Ip
ip@aaos.org
847-384-4035
American Academy of Orthopaedic Surgeons
Source:Eurekalert

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