Shooting down those postop clots.

Shooting down those postop clots

Blood clot formation in the legs during and after surgery is a relatively common side effect of decrease mobility, and one that usually resolves itself without unfortunate results. But for the few whose clots break loose and travel to the lungs, the outcome can be deadly. Called a pulmonary embolism, a clot in the lungs can kill, particularly when it occurs in the elderly. Although drugs exist to dissolve clots, physicians may not diagnose these emboli before death occurs, say researchers from Radcliffe Infirmary and John Radcliffe Hospital in Oxford, England, and from the National Heart, Lung and Blood Institute in Bethesda, Md. They report in the May 5 NEW ENGLAND JOURNAL OF MEDICINE that injection of the clot-preventing drug heparin during surgery can substantially reduce the risk of such emboli.

By reviewing data from more than 70 clinical trials with 16,000 patients, the authors found that heparin shots given before and several days after surgery "can prevent about half of all pulmonary emboli and about two-thirds of all deep-vein [clots in the leg]." Previous studies suggested leg clots are prevented by such therapy, but because pulmonary emboli are rare, those studies did not involve enough patients to assess the preventive affects of heparin or other anticoagulants against clots in lungs. Noting that many surgeons currently to not use anticlotting drugs as a preventive, the researchers suggested reconsideration of this non-use policy.