Evidence map›Paper›PMID 40587069›Full record

ArticleAnnals of surgical oncology2025

The APROVE (Anti-coagulation/Platelet Treatment in Pancreatic Resections Involving Vascular Reconstruction) Study: Results from a Worldwide Survey.

Alessio Marchetti, Jonathan Garnier, Joseph R Habib, Ingmar F Rompen, Paul C M Andel, Camila Hidalgo Salinas, Molly Ratner, Matteo De Pastena, Roberto Salvia, D Brock Hewitt and 6 more

Abstract read
PubMed Publisher
In one paragraph

Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Observational
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Alessio MarchettiDivision of Hepatobiliary and Pancreatic Surgery, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA. Alessio.marchetti@nyulangone.org.
Jonathan GarnierDivision of Hepatobiliary and Pancreatic Surgery, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA.
Joseph R HabibDivision of Hepatobiliary and Pancreatic Surgery, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA.
Ingmar F RompenDivision of Hepatobiliary and Pancreatic Surgery, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA.
Paul C M AndelDivision of Hepatobiliary and Pancreatic Surgery, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA.
Camila Hidalgo SalinasDivision of Hepatobiliary and Pancreatic Surgery, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA.
Molly RatnerDivision of Hepatobiliary and Pancreatic Surgery, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA.
Matteo De PastenaGeneral and Pancreatic Surgery Unit, Pancreas Institute, University of Verona, Verona, Italy.
Roberto SalviaGeneral and Pancreatic Surgery Unit, Pancreas Institute, University of Verona, Verona, Italy.
D Brock HewittDivision of Hepatobiliary and Pancreatic Surgery, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA.
Katherine MorganDivision of Hepatobiliary and Pancreatic Surgery, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA.
Michael D KlugerDivision of Hepatobiliary and Pancreatic Surgery, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA.
Karan GargDivision of Vascular Surgery, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA.
Ammar A JavedDivision of Hepatobiliary and Pancreatic Surgery, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA.
Christopher L WolfgangDivision of Hepatobiliary and Pancreatic Surgery, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA.
Greg D SacksDivision of Hepatobiliary and Pancreatic Surgery, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAntithrombotic therapy (AT) aims to strike a balance between preventing thromboembolic and hemorrhagic complications. However, evidence for AT management after pancreatectomy with vascular reconstruction is lacking. We aimed to provide an overview of the current use of AT for pancreatic surgery with vascular reconstructions. PATIENTS AND

methodsA web-based survey was distributed to 123 surgeons from high-volume pancreas centers (>50 pancreatic resections/year). AT management after different types of vascular reconstruction were investigated. An "aggressive" protocol was defined as the use of any AT protocol other than prophylactic heparin, aspirin, or their combination.

resultsThe survey was completed by 80 surgeons (59% Europe, 30% USA, 11% Asia). In Europe/Asia, prophylactic heparin was the most commonly reported protocol after partial venous resection/end-to-end anastomosis/human graft (71%/65%/50%, respectively), and an "aggressive" protocol (86%) was the most frequently used after prosthetic graft reconstruction. Conversely, in the USA, prophylactic heparin + aspirin was the most commonly reported protocol after all types of venous reconstruction. Following arterial reconstruction, heparin + aspirin was the most commonly reported protocol, regardless of region. An "aggressive" protocol was more frequently used in Europe/Asia (odds ratio (OR) 1.28; p < 0.001) and following vein reconstruction with either human graft (OR 1.2; p = 0.007) or prosthetic graft (OR 1.56, p <0.001), while ultrasound (OR 1.65; p < 0.001) and arterial reconstruction (OR 1.64; p < 0.001) were significantly associated with antiplatelet use.

conclusionsIn an international cohort of high-volume pancreas surgeons, significant variation in the use of AT following pancreatectomy with vascular reconstruction was observed. This variation was driven by geographical differences and the type of vascular reconstructions performed. In an international cohort of high-volume pancreas surgeons, this Worldwide Snapshot Survey analyzed the current use of antithrombotic therapy for pancreatic surgery with vascular reconstruction. A significant heterogeneity in antithrombotic practice was found and it was mainly driven by geographical differences and the type of vascular reconstructions performed.

Indexed as

AnticoagulantsFibrinolytic AgentsPancreatectomyPancreatic NeoplasmsPlastic Surgery ProceduresPlatelet Aggregation InhibitorsPostoperative ComplicationsPractice Patterns, Physicians'Vascular Surgical ProceduresAspirinHeparinHumansPrognosisSurveys and QuestionnairesAnticoagulantsAspirinFibrinolytic AgentsHeparinPlatelet Aggregation InhibitorsAnticoagulantsAntiplateletsAntithrombotic therapyPancreatic surgeryVascular reconstruction

Identifiers

PMID40587069

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.