ArticleBlood vessels, thrombosis & hemostasis2026
Thromboembolic and hemorrhagic risks after mastectomy with vs without direct-to-implant reconstruction.
Article in Blood vessels, thrombosis & hemostasis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Immediate direct-to-implant (DTI) breast reconstruction after mastectomy provides aesthetic and logistic advantages, including single-stage restoration and avoidance of tissue expansion. However, concerns persist that increased operative duration and procedural complexity may elevate thromboembolic and hemorrhagic risk. This study compared 90-day postoperative complication rates between mastectomy and mastectomy+DTI reconstruction. A multicenter cohort study was conducted using the TriNetX Research Network. Adult female patients with breast cancer undergoing mastectomy with or without immediate DTI between 2010 and 2025 were included; autologous and staged reconstructions were excluded. Propensity score matching (1:1) balanced demographics, body mass index, comorbidities, oncologic history, and preoperative medications. Outcomes included hematoma, acute deep vein thrombosis (DVT), and pulmonary embolism (PE). After matching, 11 538 patients (5769 pairs) were analyzed. Mastectomy+DTI was associated with lower hematoma rates (54 patients [0.94%] vs 81 [1.40%]; risk ratio [RR], 0.675; 95% confidence interval [CI], 0.48-0.95;
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