Anticoagulation in abdominal aortic aneurysm surgery: the approach of vascular surgeons in Great Britain and Ireland.

A questionnaire was sent to 283 vascular surgeons in Great Britain and Ireland regarding their use of heparin in elective abdominal aortic aneurysm surgery. The answers form the basis of this study and show that there is great variation. The majority of surgeons routinely anticoagulate their patients peroperatively. Heparin is usually given intravenously--most giving the drug 2 to 3 min prior to cross clamping the aorta. Approximately half of the respondents use the same dose in all patients, whilst the remainder vary the dose, usually on the basis of weight or "size". Most surgeons use 5000 units but the range of dose varies from 400 to 20,000 units. Just under a quarter of surgeons continue to anticoagulate their patients postoperatively, almost all of these using subcutaneous heparin for prophylaxis against deep vein thrombosis. Only approximately 10% of surgeons routinely reverse the heparin with protamine.