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Query: UMLS:C0149871 (deep vein thrombosis)
 12,364 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A concentrated and a diluted heparin solution (Vitrum AB) have been evaluated in a controlled blind study, using a standard dosage of 5 000 IU, given every 12 hours subcutaneously. 167 patients undergoing abdominal surgery were randomized into three groups: 63 received diluted heparin 5 000 IU/ml, 43 received concentrated heparin 25 000 IU/ml and 61 patients served as controls. 80 per cent of the patients suffered from malignant disease. Deep venous thrombosis (DVT), diagnosed with the 125I-fibrinogen method, was found in 16% of the patients receiving diluted heparin, in 23% of those receiving concentrated heparin and in 33% of the controls. To evaluate the amount injected, an in vitro experiment was performed in which the intended dose was 5 000 IU. The measured amount of the concentrated heparin solution was significantly less than 5 000 IU. It is concluded that the frequency of DVT after gastrointestinal operations can be reduced significantly (in the present study from 33 to 16%) by administering diluted calcium heparin every 12 hours for 6--8 days. The concentrated heparin solution did not significantly reduce postoperative DVT, possibly on account of variations in the dosage. Diluted heparin prophylaxis can be achieved without serious side effects.
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PMID:Concentrated or diluted heparin prophylaxis of postoperative deep venous thrombosis. 36 24

Four low-dose heparin regimens were compared with respect to the postoperative frequency of deep venous thrombosis (DVT) diagnosed with the 125I-fibrinogen method and other thrombosis variables as well as to peroperative and postoperative bleeding. The study comprised 204 patients undergoing gastrointestinal surgery who received 5,000 IU of either calcium heparin or sodium heparin (Vitrum AB) subcutaneously 2 hours before the operation and either every 8 or every 12th hours afterwards for 6--8 days. DVT was diagnosed in 17 and 16% of the patients who received calcium heparin every 8th or 12th hour respectively and in 11 and 10% respectively of those given sodium heparin every 8th or 12th hour. The differences in the incidence of DVT between the four groups were not statistically significant. An 8-hourly regimen was not accompanied by more bleeding incidents than a 12-hourly regimen. Sodium heparin was associated with a significantly increased number of patients who required blood transfusion and had more bruising at the injection site. It is concluded that the safest, most practical and still effective of the four investigated low-dose heparin regimens is calcium heparin 5,000 IU/ml administered 2 hours before the operation and every 12 hours afterwards for the first postoperative week.
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PMID:Optimal regimen of low-dose heparin prophylaxis in gastrointestinal surgery. 46 44

A randomized open trial was undertaken to compare the antithrombotic efficacy of a low molecular weight heparin (LMWH; Sandoparin) with that of dextran 70 in patients undergoing surgery for hip fracture. One hundred thirteen patients received LMWH once daily subcutaneously at a fixed dosage while 103 patients received intravenous dextran 70. Postoperative deep vein thrombosis (DVT) was assessed by a diagnostic algorithm using the 125Iodine fibrinogen uptake test as screening and Duplex ultrasonography and/or ascending venography as confirming techniques for suspected DVT. The frequency of DVT was significantly lower in the LMWH group than in the dextran group (15.5 versus 32.6%, p less than 0.005). Proximal DVT was rare in both groups (LMWH: 2%, Dextran: 1%). Only one case of fatal fat pulmonary embolism was observed during the 10 day prophylaxis period in a patient receiving Dextran. Three cases of pulmonary embolism occurred later; one fatal event in the dextran group on day 14, and two cases in the LMWH group (one fatal and one non-fatal event) on day 14 and 17, respectively. There was no major bleeding complication in either group. We conclude that the LMWH we used is safe, was well tolerated, and has a significantly better thromboprophylactic effect than dextran 70.
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PMID:Prevention of deep vein thrombosis in patients with hip fractures: low molecular weight heparin versus dextran. 128 62

471 consecutive patients, suspected clinically of a deep venous thrombosis of the lower limbs, underwent two-level ultrasonography. The reliability of the method was assessed by phlebographic comparison in 185 of them (whenever ultrasonography was positive and in one case out of five when negative). Results were striking: 94 per cent sensitivity (100% by approximation) and 86 per cent specificity. The 286 patients who did not undergo phlebography and in whom ultrasonography was negative were followed up for a period of 1 to 12 months (mean: 7.2 months). 119 were not given anticoagulants and 167 were treated with Calciparine (subcutaneous calcium heparin) at the preventive dose 0.20 ml b.i.d. for 7 days. Only two cases of phlebitis were detected: one 9 days after the investigation and the other 8 months later, following exposure to a new thrombogenic risk. There were no fatal pulmonary emboli. No difference was found between the two groups. In total, two-level ultrasonography was shown to be reliable in comparison with phlebography but, above all, when the result was negative the absence of treatment had no untoward effect on the patient.
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PMID:[Venous echography. What value should be attributes to a negative result?]. 195 71

In a randomized, prospective, double-blind trial, the effect of conventional low-dose heparin (5,000 units every 8 hours) was compared with that of a low molecular weight fragment (2165 LMWH, Kabi Vitrum AB, starting 2,500 units 2 hr before surgery, and then 5,000 units subcutaneously every morning for 9 days). A total of 90 patients admitted because of hip fracture fulfilled the inclusion criteria and were analyzed for development of pulmonary embolism and deep vein thrombosis: 46 patients were included in the low molecular weight heparin (LMWH) group, and 44 in the conventional heparin group. Two and three, respectively, died before diagnostic tests were performed. In the remaining patients a ventilation-perfusion lung scan was performed 8 days after intervention. In the first 57 patients studied a bilateral ascending venography was performed on the ninth day only if clinical symptoms suggested a deep venous thrombosis. Because of the rate of venous thrombosis detected in those patients was unexpectedly low, venography was requested in the remaining 33 patients, even if the screening tests were negative. Pulmonary embolism occurred in six patients, all in the LMWH group. Deep vein thrombosis occurred in 14 patients in the LMWH group and in six patients in the conventional heparin group. Both differences are statistically significant. Mortality did not differ between the groups, nor did haemorrhagic complications. Our findings suggest that, in patients with hip fracture, LMWH is not useful at the dosage used.
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PMID:A prospective double-blind trial of a low molecular weight heparin once daily compared with conventional low-dose heparin three times daily to prevent pulmonary embolism and venous thrombosis in patients with hip fracture. 216 34

In Leriche's "maladie post-operatoire" one of the most frequent and dangerous complications is the deep vein thrombosis (DVT). In general surgery its occurrence is between 10 and 40%, closely related to factors like patient's age, postoperative immobilization, type and time of surgery. Low molecular weight heparins (LMWH) have been recently introduced as a therapy to prevent postoperative DVT in high risk patients. LMWH seem to have all advantages of classical heparin products without their side effects. Eighty eight patients who underwent general surgery were studied in a clinical controlled trial about effectiveness of a new LMWH (Fluxum) for the prevention of postoperative DVT: 44 were treated with Calcium-heparin and 44 were treated with Fluxum. Both drugs decreased significantly the percentage of DVT, but Fluxum seemed to be better tolerated for its single-daily subcutaneous administration.
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PMID:[Role of low molecular weight heparin in the prevention of postoperative deep venous thrombosis. Our experience in 88 cases]. 256 10

The analysis of the descriptive data from the present trial leads to the following conclusions. A statistically detectable influence of the risk factors for advanced age (for Fraxiparin) are body weight above 80 kg (for calcium heparin), and malignant disease on the development of postoperative DVT was observed. In general, some influence of these risk factors persisted even though prophylactic medication was administered. The statistical considerations on risk factors do not permit any predictions for the individual patient concerning the possible risk of developing DVT. The levels of transaminases and gamma-GT increased by 20 to 30% in both groups during the treatment period. The occurrence of wound hematoma in patients operated on for hernia compared with patients with other surgical interventions revealed a clear dependence of this parameter on the type of operation performed. In keeping with other tolerance data no differences between either treatment was observed concerning the rate of wound hematoma in patients undergoing herniotomy. As to the frequency of DVT, a considerable difference between men and women was recorded in the Fraxiparin group. However, this observation needs to be confirmed in further trials. No difference was detected concerning the onset of DVT in either treatment group: 70% of the thromboses occurred within 3 days after surgery. Significantly, fewer thromboses with clinical signs and fewer proximal vein thromboses occurred in the Fraxiparin group. This seems to be most important for the clinician, since it indicates a twofold effect of the LMW heparin Fraxiparin: Both the frequency of postoperative DVT and the severity of these complications were significantly reduced.
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PMID:Descriptive analysis of the European Fraxiparin Study. 268 91

A multicentric study was carried out involving six italian departments of general surgery to assess the efficacy of a low molecular weight (LMW) heparin called Fluxum compared to standard calcium heparin in low doses for prevention of postoperative thromboembolic complications (deep vein thrombosis and pulmonary embolism). 610 patients were treated; 308 (50.5%) of whom were treated with Fluxum at doses of 4,000 or 8,000 I.U. Axa once a day by subcutaneous injection and 302 (49.5%) with heparin calcium at doses of 5,000 I.U. two or three times a day by subcutaneous injection. We observed a total of 29 deep vein thrombosis (4.7%); 10 (3.2%) from the group treated with LMW heparin and 19 (6.3%) from the comparative group. During the study 4 (0.65%) pulmonary embolism were found, 1 (0.32%) in the group treated with LMW heparin and 3 (1%) in the group treated with calcium heparin. None serious hemorrhagic accident was reported during the study. The antithrombotic prophy laxis carried out with Fluxum was on the whole better tolerated than the treatment of the other group, registering a lower frequency of hematomas at the injection and surgical wound sites.
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PMID:A multicentre study on LMW-heparin effectiveness in preventing postsurgical thrombosis. 285 Mar 22

Eighty patients undergoing pelvic or abdominal surgery for cancer were randomized in two groups for prevention of postoperative thromboembolism: 40 patients received a 15,000 IU day-1 Calciparine prophylaxis and 40 patients a 5000 anti-Xa U/d Fragmin prophylaxis for 10 days. In the Calciparine group, two patients (5%) developed postoperative pulmonary embolism but none developed it in the Fragmin group. Two patients in the Fragmin group (5%) developed isotopic DVT, which was not confirmed by phlebography. There was no deep vein thrombosis of the lower limbs in the two groups. Important postoperative bleeding (one patient in the Calciparine group and two patients in the Fragmin group) was similar in both groups. Moderate and minor bleeding were significantly lower in the Fragmin group. Haemoglobin and haematocrit changes, total blood loss and transfusion requirements were not different in both groups. It is concluded that, over a 10-day period, one daily 5000 U Fragmin prophylaxis was as effective and safe as three daily 5000 IU Calciparine injections.
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PMID:Low dose heparin versus low molecular weight heparin (Kabi 2165, Fragmin) in the prophylaxis of thromboembolic complications of abdominal oncological surgery. 285 11

In a prospective, randomized multicentre trial the efficacy and safety of the low molecular weight heparin (LMWH) fraction Fraxiparin and unfractionated calcium heparin (Calciparin) were compared for the prevention of postoperative deep vein thrombosis. Of 1909 patients included in the trial 1896 underwent abdominal surgery and received either one daily subcutaneous injection of 7500 anti-Xa units Fraxiparin or 5000 units calcium heparin three times a day subcutaneously. Elastic compression stockings were worn by both groups of patients in the postoperative period. Before randomization the patients were stratified in two subgroups with or without malignant disease. To assess the rate of deep vein thrombosis (DVT), 125I-labelled fibrinogen leg scanning was performed daily for 7 postoperative days. Positive results were confirmed by phlebography whenever possible. Venous thrombosis occurred in 27 of 960 patients (2.8 per cent) given Fraxiparin and in 42 of 936 patients (4.5 per cent) given calcium heparin (P = 0.034). The rates of proximal vein thrombosis were 0.4 per cent (4 patients) and 1.4 per cent (13 patients) respectively (P less than 0.05). Pulmonary embolism occurred in 2 of 960 patients (0.2 per cent) treated with Fraxiparin and in 5 of 936 patients (0.5 per cent) treated with calcium heparin. The two treatments were equally well tolerated. Intra- and postoperative blood loss, the number of wound haematomas as well as frequency and volume of transfusions were similar in both groups. The present trial demonstrates that a single daily subcutaneous injection of Fraxiparin is more effective than the established low dose subcutaneous heparin prophylaxis with 5000 units three times per day in preventing postoperative DVT after abdominal surgery in patients wearing compression stockings.
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PMID:Comparison of a low molecular weight heparin and unfractionated heparin for the prevention of deep vein thrombosis in patients undergoing abdominal surgery. The European Fraxiparin Study (EFS) Group. 290 87


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