Tromboosiprophylaksiat

Tromboosiprophylaksiat is the set of medical and surgical measures aimed at preventing thromboembolic events, primarily venous thromboembolism (VTE) such as deep vein thrombosis (DVT) and pulmonary embolism (PE). It is implemented in patients at elevated risk due to surgery, immobilization, cancer, pregnancy, or chronic medical illness. Risk assessment using validated tools (for example, Caprini or Padua scores) guides decisions on prophylaxis.

Prophylaxis strategies fall into pharmacological and mechanical categories. Pharmacological methods use anticoagulants to reduce clot formation, including low-molecular-weight heparin, unfractionated heparin, fondaparinux, and, in selected patients, direct oral anticoagulants. Mechanical methods include graduated compression stockings and intermittent pneumatic compression devices, sometimes combined with early mobilization. In patients where anticoagulation is contraindicated, vena cava filters may be considered in specific circumstances.

Guidelines emphasize balancing thrombotic risk against bleeding risk, with individualized duration. Perioperative prophylaxis is common for major surgery, with extended prophylaxis after high-risk procedures indicated by guidelines. Special populations, such as pregnant people or those with cancer, require tailored regimens and multidisciplinary management.

Contraindications to pharmacological prophylaxis include active major bleeding and significant bleeding risk; monitoring and avoidance of drug interactions are important. Spinal or epidural procedures require attention to timing with anticoagulants to minimize risk of hematoma.

Outcomes: effective tromboosiprophylaksiat reduces incidence of DVT and PE and associated mortality, but carries bleeding and rare immune-mediated risks.