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2013-12-04T19:10:36+05:30
2013-12-04T19:10:36+05:30
2013-12-04T19:10:36+05:30
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[(so)-294.9(s)17.7(m)15.1(ok)30.7(in)24.7(g)-301.6(c)13.4(e)12.8(s)0(s)29(a)13.1(t)18.5(i)0(o)25.3(n)-306.9(s)17.7(h)15.6(ou)27.5(l)15.4(d)-306.5(b)14.6(e)-309.7(e)19.1(n)0(-)]TJ
-11.3812 -1.2203 TD
-.0139 Tc
[(cou)-13.9(r)15.7(aged)-276.1(at)-279.9(a)5.6(n)-13.9(y)9.9(t)4.6(ime)-279.4(p)-13.9(r)9.3(e)5.2(o)-13.9(p)13.6(er)4.4(ativ)4.3(ely.)]TJ
/F1 1 Tf
0 -2.447 TD
0 Tc
[(Prophylactic)-339.6(Inferior)-329.8(Vena)-334.9(Cava)-338.5(Filters)]TJ
/F6 1 Tf
1.1128 -1.8337 TD
[(Prophylactic)-487.5(inferior)-482.9(vena)-490.4(cava)-479.6(\(IVC\))-486.6(lters)-483.1(are)-487(not)-480.8(re-)]TJ
-1.1128 -1.2203 TD
[(commended)-221.4(for)-225.2(routine)-220.8(placement)-226.2(in)-215.6(obese)-223.3(patients)-224.9(going)-220.9(for)]TJ
T*
[(bariatric)-372.1(surgery.)-376.1(IVC)-371.8(lters)-375.6(carry)-371.3(the)-376.8(risk)-370.4(of)-376.3(complications)]TJ
0 -1.2266 TD
[(directly)-394.2(related)-392.7(to)-388.9(the)-395.8(lter)-387(itself,)-397.8(including)-392.2(lter)-393.3(migration)]TJ
0 -1.2203 TD
[(and)-303.1(IVC)-302.3(thrombosis.)]TJ
6.7246 0 0 5.9768 144.5102 159.874 Tm
(55)Tj
8.9663 0 0 8.9663 153.9212 155.9055 Tm
[(In)-302.7(fact,)-306.2(one)-303.2(study)-307.7(showed)-302.9(that)-307.3(Roux-)]TJ
-10.2494 -1.2203 TD
[(en-Y)-317.8(gastric)-312.7(bypass)-315.8(surgery)-316.3(patients)-319.8(with)-312.5(an)-312.7(IVC)-314.9(lter)-317.4(were)]TJ
0 -1.2266 TD
[(more)-437.2(likely)-436.6(than)-443(those)-437.8(without)-443.6(to)-439.5(have)-433.5(a)-442.1(fatal)-433.5(pulmonary)]TJ
0 -1.2203 TD
(embolism.)Tj
6.7246 0 0 5.9768 102.7275 126.9921 Tm
(55)Tj
8.9663 0 0 8.9663 112.1385 123.0236 Tm
[(Furthermore,)-299.3(analysis)-301.1(of)-300.4(data)-293.3(from)-298.7(the)-300.9(Bariatric)]TJ
-5.5895 -1.2203 TD
[(Outcomes)-195.4(Longitudinal)-202.6(Database)-195.7(showed)-195.4(that)-193.5(the)-193.4(risk)-199.6(of)-192.9(VTE)]TJ
T*
[(was)-318.6(greater)-321.7(in)-316.7(patients)-326.1(with)-318.8(an)-319(IVC)-321.2(lter)-317.4(\(hazard)-322.2(ratio)-316.8(7.66;)]TJ
0 -1.2266 TD
[(95%)-367.4(condence)-374.3(interval)-365.9(4.5512.91\).)]TJ
6.7246 0 0 5.9768 206.3055 94.1669 Tm
(56)Tj
8.9663 0 0 8.9663 216.2834 90.1417 Tm
[(At)-374.9(this)-369.1(time,)-364.8(it)-370.7(is)-365.2(not)]TJ
-17.2046 -1.2203 TD
[(clear)-458.2(which)-453.8(subset)-457.7(of)-458.5(patients,)-455.5(if)-459.2(any,)-452.8(would)-454.9(benet)-460(from)]TJ
T*
[(prophylactic)-424.3(IVC)-416.1(lter)-418.6(placement.)-425.1(It)-413.6(may)-418.8(be)-421.6(considered)-421.5(in)]TJ
0 -1.2267 TD
[(patients)-193.3(with)-186.1(a)-182.9(prior)-186.1(history)-193.6(of)-186.6(PE)-181.4(or)-186.8(DVT,)-187.2(patients)-193.3(with)-186.1(a)-182.9(BMI)]TJ
27.9978 74.5598 TD
[(greater)-429.2(than)-430.4(60)-422.7(kg/m)]TJ
6.7246 0 0 5.9768 401.8959 729.751 Tm
(2)Tj
8.9663 0 0 8.9663 405.2975 725.7825 Tm
[(,)-426.5(those)-425.2(with)-426.3(obesity)-427.8(hypoventilation)]TJ
-10.2874 -1.2203 TD
[(syndrome,)-471.2(or)-465(those)-469.4(with)-470.6(severe)-464(venous)-471(stasis)-469(\(albeit)-467.1(with)]TJ
0 -1.2266 TD
[(careful)-283(weighing)-283.4(of)-281.4(the)-282(benets)-284.3(versus)-283.5(the)-282(risks\).)]TJ
/F1 1 Tf
0 -2.1118 TD
(Pregnancy)Tj
/F6 1 Tf
1.1128 -1.8336 TD
-.0162 Tc
[(Weight)-238(los)-16.2(s)-221.2(after)-238.2(b)-1.6(ar)-16.2(i)11.2(a)-3.1(tr)-16.2(i)11.2(c)-236.8(s)-16.2(u)12.7(r)-16.2(g)10.3(er)-16.2(y)-223.6(c)-2.8(an)-240.9(lead)-240.5(to)-240.3(impr)-16.2(o)11.9(v)-16.2(e)14.8(m)-1.1(ents)]TJ
-1.1128 -1.2203 TD
0 Tc
[(in)-310.4(po)27.5(l)15.4(y)14.6(c)13.4(y)14.6(s)17.7(t)12.2(i)15.4(c)-321.7(ov)28.1(a)13.1(r)0(y)-308.6(s)0(y)32.2(n)0(d)25.2(r)18.3(om)25(e)19.1(,)-325.4(a)13.1(n)15.6(o)16.2(v)0(u)29.5(l)15.4(a)13.1(t)12.2(i)15.4(o)16.2(n)15.6(,)-325.4(a)13.1(n)15.6(d)-325.5(m)15.1(e)19.1(n)0(s)26.9(t)12.2(r)18.3(u)0(a)24.4(l)-319.7(i)15.4(r)0(-)]TJ
T*
[(re)24.7(g)14.6(u)17.6(l)15.4(a)13.1(ri)27.4(t)18.5(i)0(e)28.2(s)0(.)]TJ
6.7246 0 0 5.9768 357.8456 650.551 Tm
-.0195 Tc
(57)Tj
8.9663 0 0 8.9663 368.2771 646.5825 Tm
0 Tc
[(T)16(h)0(i)24.7(s)-431.3(c)19.7(a)13.1(n)-433.3(i)15.4(m)15.1(p)17.6(ro)28.1(ve)-417.9(f)18.5(e)12.7(rt)30.4(i)15.4(l)0(i)24.5(t)18.5(y)-434.4(r)18.3(a)13.1(t)18.5(e)12.8(s)0(.)-415.2(C)12.5(o)16.2(n)15.6(t)12.2(r)0(a)31.4(c)13.4(e)12.7(p)17.6(t)12.2(i)15.4(o)16.2(n)]TJ
-6.1585 -1.2203 TD
[(c)13.4(o)0(u)27.5(n)15.6(se)24.1(l)15.4(i)15.4(n)15.6(g)-213.1(s)0(h)26.9(o)16.2(ul)26.7(d)-211.7(b)14.6(e)-214.9(a)-214.5(c)19.7(o)0(m)25(p)17.6(o)16.2(n)0(e)28.3(n)0(t)-199.9(o)0(f)-205.6(t)18.5(h)15.6(e)-214.9(ov)28.1(e)12.8(r)0(a)31.4(l)15.4(l)-218.5(c)19.7(ou)27.5(n)15.6(s)0(e)24.1(l)15.4(i)15.4(n)15.6(g)-213.1(f)12.2(o)16.2(r)]TJ
0 -1.2267 TD
[(a)13.1(n)15.6(y)-181.5(w)17.3(om)25(a)19.5(n)-180.4(of)-167.6(re)31(pr)23.2(o)16.2(d)16(u)17.6(c)13.4(t)12.2(i)15.4(ve)-165(a)13.1(g)14.6(e)-176.9(u)0(n)26.9(d)16(e)12.7(r)18.3(g)14.6(o)0(i)25.3(n)15.6(g)-181.5(b)14.6(a)19.5(r)0(i)27.4(a)13.1(t)18.5(r)0(i)27.4(c)-182.6(s)17.7(u)0(r)29.6(g)14.6(e)12.7(r)18.3(y)14.5(.)]TJ
6.7246 0 0 5.9768 545.6125 628.6675 Tm
-.0194 Tc
(57)Tj
8.9663 0 0 8.9663 313.0582 613.7006 Tm
0 Tc
[(Th)25.2(i)15.4(s)-254.2(i)15.4(s)-254.2(e)12.7(s)17.7(pe)30.4(c)13.4(i)15.4(a)13.1(l)15.4(l)15.4(y)-257.3(i)15.4(m)15.1(p)17.6(o)16.2(rt)24.1(a)19.5(n)0(t)-244.1(f)18.5(or)-243.7(a)19.5(d)0(o)25.8(l)15.4(e)12.7(s)17.7(c)13.4(e)12.7(n)15.6(t)12.2(s)-254.2(b)14.5(e)19.1(c)13.4(a)13.1(u)17.6(se)-241.5(pr)29.6(e)12.7(g)14.6(n)15.6(a)13.1(n)15.6(c)13.4(y)]TJ
0 -1.2203 TD
[(ra)25.1(t)18.5(e)12.8(s)-254.2(a)13.1(f)18.5(t)12.2(e)12.7(r)-247.3(b)14.6(a)13.1(ri)27.4(a)19.5(t)12.2(ri)27.4(c)-252.2(s)17.7(ur)29.6(g)14.6(e)12.7(r)18.3(y)-257.3(i)15.4(n)-250(t)12.2(h)15.6(i)15.4(s)-254.2(g)14.6(r)18.3(o)16.2(u)0(p)-243(a)19.5(re)-240.9(d)16(o)16.2(ub)25.8(l)15.4(e)-252.8(t)18.5(h)15.6(a)13.1(t)-253.4(o)16.2(f)-253.4(t)12.2(h)15.6(e)]TJ
0 -1.2266 TD
[(g)14.5(e)12.7(n)15.6(e)12.7(ra)31.4(l)-522(a)13.1(d)16(o)16.2(l)15.4(e)12.8(sc)24.7(e)19.1(n)0(t)-509.7(p)17.6(op)27.5(ul)26.7(a)13.1(t)18.5(i)15.4(o)0(n)25.5(.)]TJ
6.7246 0 0 5.9768 434.7211 595.7856 Tm
-.0194 Tc
(58)Tj
8.9663 0 0 8.9663 446.0031 591.7605 Tm
-.0142 Tc
[(Ther)-14.2(e)-520.6(m).9(ay)-530.8(als)-14.2(o)-524.1(be)-532.6(an)-536.1(in-)]TJ
-14.8272 -1.2203 TD
0 Tc
[(c)13.4(r)0(e)24.7(a)19.5(se)24.1(d)-262.2(r)18.3(i)15.4(s)0(k)-252.3(o)16.2(f)-266(o)16.2(ra)31.4(l)-262.8(c)13.4(o)16.2(n)0(t)27.8(r)0(a)25.1(c)19.7(e)12.7(p)0(t)29.8(i)15.4(on)-252.8(f)12.2(a)19.5(i)15.4(l)0(u)26.7(r)0(e)-247.2(a)13.1(f)12.2(t)18.5(e)12.7(r)-266.3(b)14.6(a)19.5(ri)27.4(a)13.1(t)18.5(ri)27.4(c)-264.8(s)17.7(ur)29.6(g)14.6(e)12.7(ry)]TJ
T*
[(du)27.3(e)-195.9(t)12.2(o)-192.5(m)15.1(a)13.1(l)15.4(a)13.1(b)14.6(s)17.7(o)0(r)28.1(p)0(t)29.8(i)15.4(on)25.5(.)-192.6(T)16(he)28.3(re)24.7(f)18.5(o)0(r)28.1(e)12.7(,)-192.6(c)13.4(on)25.5(s)17.7(i)15.4(de)28.7(ra)25.1(t)18.5(i)15.4(on)-183.2(sh)26.9(o)16.2(u)0(l)26.7(d)-192.7(b)14.6(e)-195.9(g)14.5(i)15.4(ve)31(n)]TJ
0 -1.2266 TD
[(t)12.2(o)-477(no)25.5(n)15.6(o)16.2(ra)25.1(l)-477.8(f)18.5(or)28.1(m)15.1(s)-481.8(o)16.2(f)-481(c)19.7(o)0(n)25.5(t)12.2(r)18.3(a)13.1(c)13.4(e)19.1(pt)23.5(i)15.4(o)16.2(n)15.6(.)-477.1(R)14.7(e)12.7(g)14.6(a)13.1(r)18.3(d)16(in)24.7(g)-478.6(p)17.6(o)16.2(s)0(t)23.5(o)16.2(p)17.6(e)12.7(ra)31.4(t)12.2(i)15.4(ve)]TJ
0 -1.2203 TD
[(re)24.7(p)17.6(r)0(o)28.1(d)16(uc)24.7(t)18.5(i)15.4(ve)-455.9(h)15.6(e)12.7(a)13.1(l)15.4(t)12.2(h)15.6(,)-470.8(s)17.7(o)16.2(m)15.1(e)-474.1(e)19.1(xp)28.1(e)12.7(r)18.3(t)12.2(s)-469.2(a)13.1(d)16(vi)27.3(s)17.7(e)-467.8(t)12.2(h)15.6(a)13.1(t)-468.4(pa)30.7(t)12.2(i)15.4(e)12.7(n)15.6(t)12.2(s)-469.2(w)17.3(a)13.1(i)15.4(t)]TJ
T*
-.0152 Tc
[(u)-15.2(n)11.7(til)-233.7(a)-2.1(ctive)-236.4(w)-15.2(e)14.9(i).2(gh)-15.2(t)-227.7(l).2(oss)-237.8(h).4(as)-237.8(stop)-15.2(p)13.7(e)-2.5(d)-233.2(b)-.7(efor)-15.2(e)-224.5(b)-.6(ecomi)-15.2(n)9.5(g)-234.6(p)2.4(r)-15.2(e)9.5(gnant.)]TJ
T*
0 Tc
[(Th)25.2(i)15.4(s)-241.6(t)12.2(y)14.6(pi)26.7(c)19.7(a)13.1(l)15.4(l)15.4(y)-244.7(o)16.2(c)13.4(c)13.4(u)0(r)29.6(s)-247.9(1)19.5(2)13.1()13.1(2)19.5(4)-246.1(m)15.1(o)16.2(n)15.6(t)12.2(h)15.6(s)-247.9(p)17.6(os)27.5(t)12.2(o)16.2(pe)30.4(ra)25.1(t)18.5(i)15.4(ve)24.7(l)15.4(y)-244.7(a)19.5(n)15.6(d)-249.6(a)19.5(l)15.4(l)15.4(o)0(w)27.2(s)]TJ
0 -1.2266 TD
[(pa)24.4(t)18.5(i)15.4(e)12.8(n)15.6(t)12.2(s)-437.6(t)12.2(o)-439.1(a)13.1(c)13.4(h)15.6(i)15.4(e)12.7(v)18.2(e)-442.5(t)12.2(h)15.6(e)12.7(i)15.4(r)-437(we)30.1(i)15.4(g)14.5(ht)27.8(-)12.2(l)15.4(o)16.2(s)0(s)-426.3(g)14.6(o)16.2(a)13.1(l)15.4(s)-443.9(a)19.5(n)0(d)-430(p)17.6(re)31(ve)24.7(n)15.6(t)12.2(s)-437.6(t)12.2(h)15.6(e)]TJ
0 -1.2203 TD
[(f)12.2(e)12.8(t)12.2(u)17.6(s)-519.8(f)12.2(ro)28.1(m)-522.4(b)14.6(e)19.1(i)15.4(ng)-507.3(e)12.7(x)16.8(po)27.5(se)30.4(d)-521.5(t)12.2(o)-521.3(r)0(a)31.4(p)0(i)26.7(d)-521.5(m)15.1(a)19.5(t)12.2(e)12.7(r)18.3(n)0(a)28.7(l)-522(we)30.1(i)15.4(g)14.6(ht)-509.7(l)15.4(o)16.2(ss)29(.)]TJ
6.7246 0 0 5.9768 545.6125 508.0818 Tm
-.0194 Tc
(59)Tj
8.9663 0 0 8.9663 313.0582 493.1715 Tm
0 Tc
[(Ac)24.6(h)15.6(i)15.4(e)12.7(v)18.2(in)24.7(g)-503.9(p)17.6(re)24.7(g)20.9(n)0(a)28.7(n)0(c)28.9(y)-503.9(pr)29.6(i)15.4(o)0(r)-490.3(t)12.2(o)-502.3(t)12.2(h)15.6(i)15.4(s)-507.1(m)15.1(a)19.5(y)-503.9(b)14.6(e)-505.7(a)13.1(s)17.7(so)27.5(c)13.4(i)15.4(a)13.1(t)18.5(e)12.7(d)-502.5(wi)26.5(t)18.5(h)]TJ
0 -1.2266 TD
[(c)13.4(o)0(n)25.5(g)14.6(e)19.1(n)0(i)24.7(t)18.5(a)13.1(l)-186.9(a)13.1(b)14.6(n)15.6(o)16.2(rm)27(a)19.5(l)15.4(it)27.6(i)15.4(e)12.7(s)-184.7(l)15.4(in)24.7(k)14.6(e)19.1(d)-186.4(t)12.2(o)-186.1(s)0(u)28.9(b)14.5(o)16.2(p)0(t)29.8(i)0(m)24.2(a)19.5(l)-186.9(n)15.6(ut)23.5(r)18.3(i)15.4(t)12.2(i)15.4(o)16.2(n)0(a)28.7(l)-186.9(st)29.8(a)13.1(t)12.2(u)17.6(s)]TJ
0 -1.2203 TD
-.015 Tc
[(and)-283.6(m).1(icro)-15(n)10.5(u)2.6(tr)-15(i)12.4(e)4.1(n)-15(t)-271.8(decien)-15(c)13.9(y.)]TJ
6.7246 0 0 5.9768 425.7637 475.1999 Tm
-.0195 Tc
(60)Tj
/F1 1 Tf
8.9663 0 0 8.9663 313.0582 452.296 Tm
0 Tc
(Conclusion)Tj
/F6 1 Tf
1.1128 -1.8336 TD
[(As)-432.7(outlined)-435.3(above,)-433.9(there)-434.3(are)-430.1(several)-435.6(aspects)-433.1(to)-433.2(consider)]TJ
-1.1128 -1.2203 TD
[(carefully)-278.3(when)-273.9(evaluating)-281.9(patients)-275.5(for)-275.8(bariatric)-270.9(surgery.)-281.3(This)]TJ
T*
[(summary)-546.2(provides)-544.4(a)-537(concise)-546.9(evidence-based)-543.1(approach)-545.3(to)]TJ
0 -1.2266 TD
[(managing)-439.4(the)-440(obese)-431.9(patient)-438.6(preoperatively)-442.4(and)-435.9(navigating)]TJ
0 -1.2203 TD
[(the)-288.3(unique)-279.5(challenges)-283.7(presented)-288.1(by)-280.7(this)-280.6(patient)-280.5(population.)]TJ
/F1 1 Tf
0 -2.1119 TD
[(Summary)-336(Recommendations)]TJ
/F11 1 Tf
0 -1.8336 TD
[(Bariatric-specic)-342.8(history)-333(and)-329.4(physical)]TJ
/F12 1 Tf
7.9702 0 0 7.9702 323.0361 341.518 Tm
()Tj
/F6 1 Tf
8.9663 0 0 8.9663 331.4834 340.2141 Tm
[(Screen)-450.6(for)-446.5(metabolic)-447.3(causes)-445.3(of)-445.8(obesity)-446.8(and)-442.2(obesity-re-)]TJ
0 -1.2203 TD
[(lated)-335.2(comorbidities.)]TJ
/F12 1 Tf
7.9702 0 0 7.9702 323.0361 319.5779 Tm
()Tj
/F6 1 Tf
8.9663 0 0 8.9663 331.4834 318.2739 Tm
[(Reconcile)-294(medications,)-295.4(with)-287.2(specic)-292.2(focus)-296(on)-284.4(orexigenic)]TJ
T*
(medications.)Tj
/F12 1 Tf
7.9702 0 0 7.9702 323.0361 297.6944 Tm
()Tj
/F6 1 Tf
8.9663 0 0 8.9663 331.4834 296.3904 Tm
[(Perform)-344.9(a)-341(complete)-339.9(social)-338.7(history,)-342(including)-347.9(discussion)]TJ
T*
[(of)-376.3(support)-376.1(systems,)-375.9(active)-376.5(or)-370.2(past)-375.7(substance)-377.7(abuse,)-376.1(di-)]TJ
0 -1.2266 TD
[(etary)-340.1(habits,)-331.7(and)-334.7(exercise)-335.5(habits.)]TJ
/F12 1 Tf
7.9702 0 0 7.9702 323.0361 264.8125 Tm
()Tj
/F6 1 Tf
8.9663 0 0 8.9663 331.4834 263.5086 Tm
[(Mental-health)-345(screening.)]TJ
/F11 1 Tf
-2.055 -2.1119 TD
[(Initial)-342(laboratory)-329.9(workup)]TJ
/F12 1 Tf
7.9702 0 0 7.9702 323.0361 229.4361 Tm
()Tj
/F6 1 Tf
8.9663 0 0 8.9663 331.4834 228.1322 Tm
[(Fasting)-307.9(blood)-301(glucose,)-300(renal)-304.2(function,)-308.4(liver)-299.3(prole,)-305(lipid)]TJ
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[(19.)-504(Wesorick)-459.1(DH,)-467.7(Eagle)-460.4(KA.)-457.9(The)-464.9(preoperative)-466(cardiovascular)]TJ
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[(diac)-333.7(risk)-334.3(of)-335.4(noncardiac)-339.4(surgery.)-335.6(Circulation)-341(2006;113:1361.)]TJ
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[(23.)-504(Fleisher)-439.9(LA,)-444.7(Beckman)-444(JA,)-445.5(Brown)-445.9(KA,)-444.5(Calkins)-445.8(H,)-441(Chaikof)]TJ
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[(AHA)-336(focused)-341.3(update)-341(on)-339.8(perioperative)-345.7(beta)-333.8(blockade)-343(incor-)]TJ
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[(tive)-703.5(cardiovascular)-714.7(evaluation)-715.8(and)-707.3(care)-707.2(for)-713.6(noncardiac)]TJ
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