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Fig. 1

(A) A 72-year-old female patient was referred to our hospital with left femoral neck fracture. She did not receive any thromboprophylaxis for 7 days following hip fracture.

(B) On the next day, she underwent a bipolar hemiarthroplasty of the left hip with a modular cementless stem. At 6 hours after the operation, she suddenly complained of dyspnea and chest pain.

(C) Enhanced computed tomography revealed filling defects (arrows) in the right and left pulmonary arteries. She was diagnosed with an acute pulmonary thromboembolism, and immediately underwent an open pulmonary thromboembolectomy.

(D) Thromboembolic material removed from the right and left pulmonary arteries during pulmonary endarterectomy. Her postoperative course was uneventful, and she was able to ambulate with a walker on postoperative day 7.

Table 1

Risks of deep vein thrombosis in hospitalized patients not receiving thromboprophylaxis (ACCP, 2008)

DVT: deep vein thrombosis, HFS: hip fracture surgery, SCI: spinal cord injury.

Table 2

Risk factors for venous thromboembolism (ACCP, 2008)

VTE: venous thromboembolism.

Table 3

Levels of thromboembolism risk and recommended thromboprophylaxis in hospital patients (ACCP, 2008)

DVT: deep vein thrombosis, VTE: venous thromboembolism, HFS: hip fracture surgery, SCI: spinal cord injury, LMWH: low-molecular-weight heparin, LDUH: low-dose unfractionated heparin, INR: international normalized ratio.

Table 4

ACCP guideline for VTE prevention (8th edition, 2008)

VTE: venous thromboembolism, HFS: hip fracture surgery, LMWH: low molecular weight heparin, INR: international normalized ratio, LDUH: low-dose unfractionated heparin.

Table 5

Surgical patients and patients with trauma who are at risk of VTE (NICE, 2010)

VTE: venous thromboembolism, BMI: body mass index.

Table 6

Patients who are at risk of bleeding (NICE, 2010)

INR: international normalized ratio.

Table 7

NICE clinical guideline for reducing the risk of venous thromboembolism (UK, 2010)

HFS: hip fracture surgery, LMWH: low molecular weight heparin, UFH: unfractionated heparin, VTE: venous thromboembolism.

Figure & Data

REFERENCES

Citations

Citations to this article as recorded by  

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