warfarin and Ankle-Fractures

A patient with trimalleolar ankle fracture was preoperatively diagnosed with deep vein thrombosis (DVT); after induction of general anesthesia, a temporary inferior vena cava filter (TIVCF) was intraoperatively placed by an anesthesiologist. This contributed to safe anesthesia management. A 65-year-old woman was scheduled to undergo surgery for a trimalleolar ankle fracture sustained in an accidental fall. Two days before surgery, leg venous ultrasonography showed DVT. On the day of surgery, after induction of general anesthesia, a TIVCF was inserted by the anesthesiologist. After surgery, the TIVCF was removed, and anesthetic management was completed. On the day after the surgery, anticoagulant treatment was administered. Approximately 3 weeks later, thrombus disappearance was confirmed, and treatment was terminated. DVT is a serious complication that may cause pulmonary thromboembolism. TIVCF is effective in the treatment of DVT, and insertion of the TIVCF used in the present study is relatively simple. TIVCF placement by anesthesiologists, who have reliable knowledge on the various approaches to veins, contributes greatly to securing perioperative patient safety. The collaboration and cooperation of several medical departments are essential for DVT treatment and enhancing perioperative patient safety.

Topics: Aged; Anesthesia, General; Anesthesia, Intravenous; Anesthesiology; Ankle Fractures; Anticoagulants; Clinical Competence; Female; Humans; Perioperative Care; Physicians; Preoperative Period; Ultrasonography; Vena Cava Filters; Venous Thrombosis; Warfarin