2018 Volume 38 Issue 5 Pages 615-621
To prevent venous thromboembolism（VTE）, it is necessary to know the latest findings of pathophysiology related to VTE such as hypoxic endothelial disorders and the hypercoagulable state associated with cancer. Vascular endothelial dysfunction generated by cusp’s hypoxic insult due to the loss of pulsatile blood flow in the lower extremities and/or regional inflammation eventually lead to thrombus formation. Thus, the ankle joint should be moved actively at least every 2 hours if a patient is awake, and in a resting state. Creating a pulsatile blood flow passively should be considered if the patient was sedated or anesthetized. Moreover, as cancer patients are in a particularly hypercoagulable state, they are prone to develop VTE and are in a high risk group for VTE in the perioperative period. In addition, there are many cases where VTE develops before surgery, so we also discuss how to manage these cases appropriately according to Japanese guidelines for managing venous thromboembolism.
