Careful perioperative management including IVC filter placement and low molecular weight heparin therapy allows for safe surgical intervention in patients with malignancy and concurrent DVT/PE.
May support IVC filter plus LMWH for surgery in malignancy with VTE; hypothesis-generating and should not yet change practice.
We describe the anaesthetic management of 45 year female patient with pre-existing deep venous thrombosis (DVT) and pulmonary embolism (PE) who was subsequently scheduled for an laparotomy. Before planning the surgical procedures, adequate anticoagulation must be achieved to prevent further complications of DVT, thromboembolism, and pulmonary embolism in particular. The risk of stopping the anticoagulation prior to surgery must be considered and adequately discussed with the patient and surgeons. The anaesthetic plan must be selected keeping in mind the coagulation status and the need of anticoagulation in the postoperative period.
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Arora et al. (2011) studied this question.
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