Low-Molecular-Weight and Unfractionated Heparin for Prevention of Venous Thromboembolism in Neurosurgery

Abstract
VENOUS thromboembolism (VTE) is a life-threatening complication of neurosurgery. The risk of pulmonary embolism in neurosurgical patients has been reported to be as high as 5%, with a mortality rate ranging from 9% to 50%.1 Analysis of the major trials indicates that pulmonary embolism is a major cause of death in neurosurgical patients. The incidence of clinically overt deep vein thrombosis (DVT) has been reported to range from 1.6% to 4%.2 The incidence of objectively proven DVT has been estimated to range from 19% to 43% in case series using fibrinogen labeled with iodine 125 (125I) to screen for DVT and from 24% to 33% in clinical trials using venography to screen for DVT.3