Embolism Health Article

Prevention

Embolism can be prevented in high risk patients through antithrombotic drugs such as heparin, venous interruption, gradient elastic stockings, and intermittent pneumatic compression of the legs. The combination of graduated compression stockings and low-dose heparin is significantly more effective than low-dose heparin alone.

Gradient elastic stockings, also called anti-embolism stockings, decrease the risk of blood clots by compressing superficial leg veins and forcing blood into the deep veins. They can be knee-, thigh-, or waist-length. Many physicians order the use of stockings before surgery and until there is no longer an elevated risk of developing blood clots. The risk of deep vein thrombosis after surgery is reduced 50% with the use of these stockings. The American Heart Association recommends that the use of graduated compression stockings be considered for all high-risk surgical patients.

Intermittent pneumatic compression involves wrapping knee- or thigh-high cuffs around the legs to prevent blood clots. The cuffs are connected to a pump which inflates and deflates, mimicking the heart's normal pumping action and reducing the pooling of blood. Intermittent pneumatic compression can be used during surgery and recovery and continues until there is no longer an elevated risk of developing blood clots. The American Heart Association recommends the use of intermittent pneumatic compression for patients who cannot take anticoagulants, for example, spinal cord and brain trauma patients.

BOOKS

"Arterial Occlusive Disease." In Professional Guide to Diseases. 5th ed. Springhouse, PA: Springhouse Corporation, 1995.

DeBakey, M. E., and A. M. Gotto. "Invasive Diagnostic Procedures." In The New Living Heart. Holbrook, MA: Adams Media Corporation, 1997.

"Disorders of the Pulmonary Circulation, " "Arterial Embolism, " and "Other Disorders Due to Physical Agents." In Current Medical Diagnosis and Treatment, 1996. 35th ed. Ed. Stephen McPhee, et al. Stamford: Appleton & Lange, 1995.

Noble, John, ed. "Arterial Emboli and Acute Thrombosis." In Textbook of Primary Care Medicine. 2nd ed. St. Louis: Mosby, 1996.

Texas Heart Institute. "Diseases of the Peripheral Arteries and Veins." In Texas Heart Institute's Heart Owner's Handbook. New York: John Wiley & Sons, 1996.

PERIODICALS

ACCP Consensus Committee on Pulmonary Embolism. "Opinions Regarding the Diagnosis of Venous Thromboembolic Disease." Chest 113, no. 2 (Feb. 1998): 499-503. Charland, Scott L., and Dawn Klinter. "Low-Molecular Weight Heraprins in the Treatment of Pulmonary Embolism." The Annals of Pharmacotherapy 32 (Feb. 1998): 258-263.

Tapson, Victor F. "Pulmonary Embolism-New Diagnostic Approaches." The New England Journal of Medicine 336, no. 20 (15 May 1997): 1449-1451.

ORGANIZATIONS

American Heart Association. 7320 Greenville Ave. Dallas, TX 75231. (214) 373-6300. <http://www.americanheart.org>.

OTHER

"Management of Deep Vein Thrombosis and Pulmonary Embolism." and "Stroke (Brain Attack)." American Heart Association. 3 Mar. 1998 <http://www.americanheart.org>.

"Warfin and Compression Treatment Prevents Coagulation in Knee ReplacementsAmerican." Academy of Orthopaedic Surgeons Online. 15 Feb. 1997. 22 Apr. 1998 <http://www.aaos.org>.

Lori De Milto

KEY TERMS

Anticoagulants—Drugs that suppress, delay, or prevent blood clots. Anticoagulants are used to treat embolisms.

Artery—A blood vessel that carries blood from the heart to other body tissues. Embolisms obstruct arteries.

Deep vein thrombosis—A blood clot in the calf's deep vein. This frequently leads to pulmonary embolism if untreated.

Emboli—Clots or other substances that travel through the blood stream and get stuck in an artery, blocking circulation.

Thrombolytics—Drugs that dissolve blood clots. Thrombolytics are used to treat embolisms.