PROPHYLAXIS AGAINST POSTOPERATIVE DEEP VEIN THROMBOSIS (DVT)- A DOUBLE-BLIND MULTICENTER TRIAL COMPARING A HEPARIN FRAGMENT GIVEN ON THE EVENING BEFORE SURGERY WITH CONVENTIONAL LOW DOSE HEPARIN

1987 ◽  
Author(s):  
D Bergqvist ◽  
J Frisel ◽  
T Hallböök ◽  
A Horn ◽  
A Lindhagen ◽  
...  
Keyword(s):  
Low Dose ◽  
Factor Xa ◽  
Multicenter Trial ◽  
Double Blind ◽  
Vein Thrombosis ◽  
Intention To Treat ◽  
Dose Heparin ◽  
Uptake Test ◽  
Deep Vein ◽  
Low Dose Heparin

Bergen, Halmstad, Goteborg and KabiVitrum AB Stockholm, Sweden and Norway. At the Xth Int. Congress on Thrombosis and Haemostasis in San Diego results from a multicenter trial on 432 patients were presented, comparing a low molecular weight heparin (LMWH) fragment (Fragmin, Kabi) once daily with low dose heparin twice daily. Prophylaxis started 2 hours preoperatively. The frequency of postoperative DVT did notdiffer (6.4 % v. 4.3 %) but the onset of thrombosis was delayed in the LMWH group. Haemorrhagic complications occurred significantly more often in the LMWH group (11.6 % v. 4.6 ?o). The results were similar independent whether the analysis was made according to the intention to treat principle or based on patients with correct prophylaxis. On the basis of these data and newer knowledge regarding the pharmacokinetics of LMWH a second prospective randomized double-blind multicenter trial on patients.older than 40 years undergoing elective abdominal surgery was started. The only difference was that the first dose of 5000 ariti-factor Xa units of LMWH was given on the evening before surgery. Only conventional low dose heparin was given 2 h before surgery. The study is designed to include 1000patients, a number which will be obtained during the spring 1987. At the time of abstract deadline 799 patients have been included. The over-all frequency of DVT (fibrinogen uptake test) is 6.8 %, the frequency of haemorrhagic complications 3.6 % and mortality 1.8 % (one fatal pulmonary embolism). These frequencies remained unaltered after inclusion of 336, 576, 655 and 799 patients. Although the code has not been broken yet, it can be concluded that the new regimen with start of prophylaxis the evening before surgery has not altered the frequency of DVT or mortality whereas the frequency of haemorrhagic side effects has decreased considerably.

Prevention of Deep-Vein-Thrombosis (DVT) in Hysterectomy Patients by Low-Dose-Heparin, Heparin-Dihydroergotamin and Acenocoumarol

1979 ◽  
Author(s):  
S. Kunz ◽  
R. C. Briel
Keyword(s):  
Low Dose ◽  
Vein Thrombosis ◽  
Dose Heparin ◽  
Common Operation ◽  
Uptake Test ◽  
Deep Vein ◽  
Mean Time ◽  
Low Dose Heparin ◽  
Calf Vein ◽  
Group 1

In major gynecological surgery an incidence of 15 - 35% DVT is found. However there are no data concerning the incidence of DVT following hysterectomy, the most common operation in gynecology. Therefore, in 288 patients undergoing elective hysterectomy a 125-J-fibrinogen uptake test was carried out, starting 2 hours postop and repeated every 24 hours for 8 days. Results: Of the 97 patients who received heparin alone (2 x 5000 IU/24 h) 15, 5% developed DVT. In the heparin-dihydroergotamin group (101 patients, 2 x 5000 IU heparin + 0 . 5 mg DHE) only 5, 9% positive scans were found (2p <0.05). In the acenocoumarol group (prophylaxis was begun 36 hrs. postop. in 90 patients) the frequency was 11.1%. Mean time for the onset in the heparin and heparin-DHE group was 4 and 3 days resp., in the acenocoumarol group 1 day. Duration of positive scans: 98, 53 and 50 hours. Localisation: 65 - 72 % calf-vein thrombosis;14 % bilateral in the heparin, 0 in the heparin-DHE and 9 % in the acenocoumarol group. No differences were registered in complications, side effects, blood volume insuction drainages, postop. fall of hemoglobin, standard morbidity and hematoma.

Hepar Inconcentration, Antithrombin III and Antiplasmin in Elective Surgery with Low Dose Heparin Prophylaxis

1979 ◽  
Author(s):  
H.O. Kruse-Blinkenberg ◽  
Johs Gormsen
Keyword(s):  
Low Dose ◽  
Antithrombin Iii ◽  
Elective Surgery ◽  
Vein Thrombosis ◽  
Dose Heparin ◽  
At Iii ◽  
Uptake Test ◽  
Deep Vein ◽  
Low Dose Heparin ◽  
Heparin Prophylaxis

Eighty patients underwent abdominal surgery in low dose heparin (Novo) 5.000 units subcutanously 2 hours preoperatively and every 8 hours until full mobilization. Clinical end points were 125J fibrinogen uptake test and venography. Heparin concentrations, antithrombin III(AT III) against IIa and Xa and antiplasmin, were measured on synthetic substrates (Kabi Diagnostica, Sweden). Deep vein thrombosis (DVT) developed in 16 patients. Heparin concentrations were identical in patients ± DVT preoperatively but the concentrations were significantly lower postoperatively on day 1-5 in the patients with DVT, AT III (against IIa)was lower pre- and postoperatively in patients with DVT, but the differences were only significant lower when measuring AT III against Xa, pre- and postoperatively. The antiplasmin level was higher in patients with malignency and in patients with DVT, and the differences were significant postoperatively (p < 0.01).

scholarly journals Combined Administration of Low Dose Heparin and Aspirin Versus low Dose Heparin Alone as Prophylaxis of Deep Vein Thrombosis (D.V.T.) After Total Hip Replacement. A Preliminary Report

1977 ◽  
Author(s):  
A. Kher ◽  
H. Flicoteaux ◽  
N. Jean ◽  
M. Blery ◽  
T. Judet ◽  
...  
Keyword(s):  
Low Dose ◽  
Treatment Groups ◽  
Vein Thrombosis ◽  
Dose Heparin ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Uptake Test ◽  
Deep Vein ◽  
Low Dose Heparin

In a prospective randomized trial, the efficacy of a prophylaxis of D.V.T. by low dose heparin alone (t.i.d.-group I-18 patients) and by low dose heparin (t.i.d.) combined with aspirin (500 mg b.i.d.-group II-15 patients) was investigated using both radioactive fibrinogen uptake test and venography. The treatment groups were comparable for all pretreatment characteristics. The incidence of isotopic D.V.T. between group I (22.2%) and group II (26.6%) was not statistically significant. There was also no significant difference in the frequency of popliteal vein thrombosis between the two groups. One non fatal pulmonary embolism occurred in group I. Correlation of phlebography with radioactive fibrinogen uptake test is 87.5%. The combination of low dose heparin and aspirin does not improve the results obtained with low dose heparin alone in the prevention of post operative D.V.T. and a tendency in increased bleeding and wound haematomas were observed with such a combination.

Low-Dose Heparin and Deep-Vein Thrombosis after Total Hip Replacement

1976 ◽  
Vol 36 (01) ◽  
pp. 157-164 ◽  
Author(s):  
P. M Mannucci ◽  
Luisa E. Citterio ◽  
N Panajotopoulos
Keyword(s):  
Deep Vein Thrombosis ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Low Dose ◽  
Control Group ◽  
Total Hip ◽  
Vein Thrombosis ◽  
Dose Heparin ◽  
Deep Vein ◽  
Low Dose Heparin

SummaryThe effect of subcutaneous low-dose heparin on postoperative deep-vein thrombosis (D. V. T.) (diagnosed by the 125I-labelled fibrinogen test) has been investigated in a trial of 143 patients undergoing the operation of total hip replacement. Two randomized studies were carried out: in one the scanning for D.V.T. was carried out daily for 7 days post operatively and in the other for 15 days. In both, the incidence of D.V.T. was significantly lower in the heparin-treated patients (P<0.005). Bilateral D.V.T. was also prevented (P<0.05), through the extension of D.V.T. to the distal veins of the thigh was not significantly reduced. Heparin treatment was, however, followed by a higher incidence of severe postoperative bleeding (P< 0.02) and wound haematoma formation (P< 0.005), and the postoperative haemoglobin was significantly lower than in the control group (P<0.005). A higher number of transfused blood units was also needed by the heparin treated patients (P<0.001).

A RANDOMIZED, DOUBLE BLIND STUDY OF A LOW MOLECULAR WEIGHT HEPARIN (KABI 2165) ONCE DAILY AND LOW DOSE STANDARD HEPARIN TWICE DAILY, IN THE PREVENTION OF POST OPERATIVE DEEP VEIN THROMBOSIS IN GENERAL SURGERY. A French Multicenter Trial

1987 ◽  
Keyword(s):  
Molecular Weight ◽  
Deep Vein Thrombosis ◽  
Low Molecular Weight Heparin ◽  
Low Dose ◽  
Multicenter Trial ◽  
Low Molecular Weight ◽  
Double Blind ◽  
Once Daily ◽  
Vein Thrombosis ◽  
Deep Vein

The efficacy and safety of a low molecular weight heparin (Kabi 2165) in preventing postoperative deep vein thrombosis (D.V.T.), was assessed in a double blind randomly allocated multicenter trial. 385 patients were included and analysed on a intention to treat basis. Kabi 2165 was given S.C. 24 hourly in 2 500 anti-factor Xa units and compared with standard low dose calcium heparin 5 000 i.u. S.C. 12 hourly in patients undergoing major abdominal or gynaecological surgery. The first dose was administered two hours before operation in both groups. The relevant characteristics of the patients in the two treatment groups were similar. The two groups were well matched for risk factors which could predispose to D.V.T.DVT was detected by the radioactive fibrinogen test. Venography was performed whenever a positive scan developed in a patient. Six (3,1 96) of 195 patients receiving Kabi 2165 and seven (3,7 96) of 190 patients in the standard heparin group developed D.V.T. No pulmonary embolism we re detected during the prophylactic regimens. There was no significant difference between the two groups in terms of blood loss during surgery, postoperative drainage, blood transfusion, wound haematoma. Mean hemoglobin levels and mean hematocrit values preoperatively and postoperatively (day 1 and 6) were :There were no statistically significant differences in both groups. No thrombocytopenia was reported in this study. The antifactor Xa activity was significantly higher in the Kabi 2165 group.In conclusion, Kabi 2165 once daily is as effective and safe as standard heparin twice daily in preventing postoperative D.V.T. in general surgery.

The Prophylaxis of Deep Vein Thrombosis with Low-Dose Heparin: A Trial

1974 ◽  
Vol 44 (3) ◽  
pp. 289-291 ◽  
Author(s):  
J. Propsting ◽  
O. Williams ◽  
M. Stathis ◽  
J. F. Mccaffrey
Keyword(s):  
Deep Vein Thrombosis ◽  
Low Dose ◽  
Vein Thrombosis ◽  
Dose Heparin ◽  
Deep Vein ◽  
Low Dose Heparin

Low Dose Heparin in the Prevention of Deep-Vein Thrombosis after Aortic Bifurcation Graft Surgery

1979 ◽  
Vol 42 (05) ◽  
pp. 1429-1433 ◽  
Author(s):  
J J F Belch ◽  
G D O Lowe ◽  
J G Pollock ◽  
C R M Prentice
Keyword(s):  
Tranexamic Acid ◽  
Low Dose ◽  
Inhibitory Effect ◽  
Intragastric Administration ◽  
Vein Thrombosis ◽  
Dose Heparin ◽  
Prolonged Duration ◽  
Deep Vein ◽  
Slide Technique ◽  
Low Dose Heparin

SummaryAn optimal inhibition of tissue fibrinolysis, studied by a histochemical fibrin slide technique in the rat stomach, was obtained by administration of tranexamic acid in a dose of 60 mg/100 g body weight. A significant fibrinolysis inhibition was found within 5 min, when tranexamic acid in this dose was given either intravenously or intragastrically. A prolonged duration of fibrinolysis inhibition was observed after intragastric administration. After 4 hr no inhibitory effect of tranexamic acid could be recorded, irrespective of the route of administration.

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