Early Pharmacologic Venous Thromboembolism Prophylaxis after Splenic Artery Embolization Is Not Associated with an Increased Risk of Rebleed.

Venous thromboembolism (VTE) prophylaxis in the setting of blunt traumatic visceral injury remains controversial. A total of 181 patients underwent splenic artery embolization (SAE) and began pharmacologic VTE prophylaxis at a median time of 59.5 hours (interquartile range, 46 hours). Six patients required splenectomy for rebleed. Fifty-one patients underwent SAE but did not receive anticoagulation therapy since they were considered low risk for VTE, and no splenectomies were performed (P = 1). Multivariate analysis showed no increased risk of need for splenectomy after beginning anticoagulation within 24 hours after SAE (P =.441). This study suggests that patients found to be at a high VTE risk should be considered for thromboprophylaxis within 24 hours after SAE.