What is the effectiveness of prophylactic treatments in preventing venous thromboembolism in high-risk groups?
A systematic review assessed the risk of thrombosis associated with thrombophilia in 3 high-risk groups: women using oral estrogen preparations, women during pregnancy, and patients undergoing major orthopedic surgery.833 This is relevant for the primary prevention of cerebral venous thrombosis and ischemic stroke from paradoxical cerebral embolism in the setting of a PFO. The effectiveness of prophylactic treatments in preventing venous thromboembolism in these groups was evaluated and found to be effective in reducing the risk of venous thromboembolism. Selective screening based on prior venous thromboembolism history was also found to be more cost-effective than universal screening. 