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    Poster Networking

    Venous Thromboembolism

    Poster Networking Session

    PB1461 - Peri-operative Venous Thromboembolism (VTE) Risk for Below Knee Amputations

    Tuesday, June 27, 2023
    18:30 – 19:30 ET
    Room: Exhibition
    Background: Patients who undergo major amputation are at high risk of venous thromboembolic (VTE) events including deep vein thrombosis (DVT), superficial vein thrombosis (SVT) and pulmonary embolism (PE) due to prolonged hospitalization, immobility and other associated risks of surgery. Despite many patients who undergo amputation having significant underlying cardiovascular comorbidities (e.g., pre-existing vascular disease), there are no standardized guidelines for duration of post-operative prophylactic anticoagulant therapy.

    Aims: The goal of this study is to describe the incidence of VTE after below knee amputation (BKA).

    Methods: We performed a retrospective review of adult patients within the Veteran Administration Central Data Warehouse (CDW) between 2015 to 2022 who underwent BKA.

    Results: Over a 7-year time period, there were 10,749 patients with a first-time below knee amputation. Of these, 472 (4.4%) patients had a new VTE event. The study population was primarily male (n=10,577, 98.4%) with an average age at BKA of 66.9 years (SD = 9.9). Approximately 32.4% patients had a history of cardiovascular disease including peripheral arterial disease. Of the VTE events, 100 (21.1%) occurred within 30 days, 147 (31.1%) occurred within 90 days and 221 (46.8%) occurred within 1 year following the amputation. DVT events were the most common (n=251, 53.2%) followed by PE (n=202, 42.8%) and SVT (n=27, 5.7%). Among DVT events, 155 were proximal (41%), 48 (13%) were distal, and 172 (46%) were unspecified.

    Conclusion(s): Following below knee amputation, 4.4% of patients had a VTE event overall with one-third of these events occurring within 90 days after amputation. Further research should focus on the role of pharmacologic prophylaxis to reduce the risk of post-amputation VTE.