I had a PE several years ago after surgery. Does it mean I will always get one?

I had a PE several years ago after surgery, does it mean that after any surgery, I will get pulmonary embolism? Is there anything I can do now before surgery to prevent this?

Doctor Answers 5

Pulmonary Embolism risk?

Since you already had a PE it is important to have had an evaluation by a Hematologist to determine your risk. 

In all likelihood you are more at risk because you already had one. Estrogen increases the risk, as well as other factors.

In addition if a surgery is done SCD's and early ambulation will help decrease the risk and sometimes early use of anticoagulants may be used.

Fort Worth Plastic Surgeon
4.7 out of 5 stars 3 reviews

Recurrent PE Risk After Surgery

Some studies show that as many as 30% of all patients undergoing surgery exceeding 1 hour under general anesthesia may develop some clots in the veins of their legs. Clearly not all or even most of these patients develop a PE. Since you have had one in the past, you are at somewhat higher risk of developing clots and potentially a second PE.

Given the circumstances, you should have a complete evaluation by a hematologist to determine any potential clotting conditions that you may have which could have caused your previous PE. His/her recommendations should be followed to minimize the chance for further clots should you decide to have surgery.

Assuming there are no intrinsic causes that may have led to your previous PE, then there are protocols that your surgeon can follow to minimize your risk of a recurrent PE. These may include the use of compression stockings and/or sequential compression devices and/or the use of anticoagulants during and after surgery or possibly even a Greenfield filter.

Regardless of what measures are taken there is no guarantee to any patient with or without a previous PE, that will not develop clots and a subsequent PE. The good news is that with proper attention to reducing PE risk, the overwhelming majority of surgeries (cosmetic or otherwise) are performed without complications of a PE. It is a calculated risk - just as the risk of being in an accident while driving is not zero.

Best wishes!

Alexander G. Nein, MD, MS, FACS
Nashville Plastic Surgeon
4.4 out of 5 stars 25 reviews

PE after surgery

Not always, but you are at high risk. You probably should get anticoagulation after surgery. You should consider the need for surgery carefully. You should also see a hematologist before you have any further surgeries.

Burton M. Sundin, MD
Richmond Plastic Surgeon
4.6 out of 5 stars 54 reviews

Need a full hematologic evaluation for a clotting disorder to stratify your risk

Having a history of PE does present some problems, and you are at a higher risk.  First, you need a full evaluation from a hematologist to find out if you have a hyper coagulable state that increases your risk of clotting.  Depending on their diagnosis, they will be able to stratify your risk for developing further clots.  Without a full hematologic work-up and a diagnosis, it is impossible to comment on whether you will develop a PE with any future surgery.  If the surgery is necessary, it is one thing.  If the surgery is elective, you, the surgeon, and the hematologist will have to assess the risk of clotting in the specific setting of the surgery desired.  If you are an appropriate risk, there will be recommendations regarding the perioperative management made by the hematologist, which may or may not include compression stockings, early ambulation, sequential compression stockings during surgery, and possibly anticoagulation.  

PE after last surgery

Hello and thank you for your question. No it does not. You are at higher risk for getting another Pulmonary embolism however. For this reason if another surgery is wanted or needed anticoagulation is needed. I have performed  tummy tuck in 2 patients who had a history of previous  p.e taking appropriate precautions as mentioned without them having any problems. Having said that if you want to undergo elective surgery you have to way the potential consequences, with your history, that could occur. 
Peter Fisher M.D. 

Peter Fisher, MD
San Antonio Plastic Surgeon
4.9 out of 5 stars 47 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.