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@article{Turner:2022:10.1097/SLA.0000000000005709,
author = {Turner, B and Machin, M and Jasionowska, S and Salim, S and Onida, S and Shalhoub, J and Davies, A},
doi = {10.1097/SLA.0000000000005709},
journal = {Annals of Surgery},
pages = {166--171},
title = {Systematic review and meta-analysis of the additional benefit of pharmacological thromboprophylaxis for endovenous varicose vein interventions},
url = {http://dx.doi.org/10.1097/SLA.0000000000005709},
volume = {278},
year = {2022}
}

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TY  - JOUR
AB  - Objective: The primary objective of this systematic review and meta-analysis was to elucidate the rate of venous thromboembolism (VTE) following endovenous varicose vein intervention with mechanical thromboprophylaxis and additional pharmacological thromboprophylaxis, versus mechanical thromboprophylaxis alone.Summary Background Data: The VTE rate following endovenous procedures is higher than other day-case procedures and could be reduced with pharmacological thromboprophylaxis.Methods: The review followed PRISMA guidelines with a registered protocol (PROSPERO: CRD42021274963). Studies of endovenous intervention for superficial venous incompetence reporting the predefined outcomes with at least 30 patients were eligible. Data were pooled with a fixed effects model.Results: There were 221 trials included in the review (47 randomised trial arms, 105 prospective cohort studies and 69 retrospective studies). In randomised trial arms, the rate of deep venous thrombosis with additional pharmacological thromboprophylaxis was 0.52% (95% CI 0.23-1.19%) (9 studies; 1095 patients; 2 events), versus 2.26% (95% CI 1.81-2.82%) (38 studies; 6951 patients; 69 events) with mechanical thromboprophylaxis alone. The rate of pulmonary embolism in randomised trial arms with additional pharmacological thromboprophylaxis was 0.45% (95% CI 0.09-2.35) (5 studies, 460 participants, 1 event) versus 0.23% (95% CI 0.1-0.52%) (28 studies, 4834 participants, 3 events) for mechanical measures alone. The rate of EHIT grade III-IV was 0.35% (95% CI 0.09-1.40) versus 0.88% (95% CI 0.28-2.70%). There was one VTE-related mortality and one instance of major bleeding, with low rates of minor bleeding.Conclusions: There is a significant reduction in the rate of DVT with additional pharmacological thromboprophylaxis and routine prescription of anticoagulation following endovenous varicose vein intervention should be considered. VTE risk for individual study participants is heterogeneous and risk stratifica
AU  - Turner,B
AU  - Machin,M
AU  - Jasionowska,S
AU  - Salim,S
AU  - Onida,S
AU  - Shalhoub,J
AU  - Davies,A
DO  - 10.1097/SLA.0000000000005709
EP  - 171
PY  - 2022///
SN  - 0003-4932
SP  - 166
TI  - Systematic review and meta-analysis of the additional benefit of pharmacological thromboprophylaxis for endovenous varicose vein interventions
T2  - Annals of Surgery
UR  - http://dx.doi.org/10.1097/SLA.0000000000005709
UR  - http://hdl.handle.net/10044/1/102834
VL  - 278
ER  -

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