Outpatient Therapy with Low-Molecular-Weight Heparins: New Perspectives for Treatment of Deep Vein Thrombosis

1998 ◽  
Vol 28 (3) ◽  
pp. 91-94
Author(s):  
H.R. Büller
Keyword(s):  
Molecular Weight ◽  
Deep Vein Thrombosis ◽  
Low Molecular Weight ◽  
Outpatient Therapy ◽  
Low Molecular Weight Heparins ◽  
Vein Thrombosis ◽  
Deep Vein

Low-Molecular-Weight Heparins in the Treatment of Deep-Vein Thrombosis

1998 ◽  
Vol 32 (5) ◽  
pp. 588-601 ◽  
Author(s):  
Pierre Martineau ◽  
Nadine Tawil
Keyword(s):  
Molecular Weight ◽  
Deep Vein Thrombosis ◽  
Clinical Efficacy ◽  
Total Mortality ◽  
Bleeding Complications ◽  
Low Molecular Weight ◽  
Laboratory Monitoring ◽  
Low Molecular Weight Heparins ◽  
Vein Thrombosis ◽  
Deep Vein

OBJECTIVE: To compare the characteristics and clinical efficacy of low-molecular-weight heparins (LMWHs) and unfractionated heparin (UFH) in the treatment of deep-vein thrombosis (DVT). Adverse effects, dosing, and cost issues are also discussed. DATA SOURCES: A MEDLINE search (January 1984–October 1997) was used to identify pertinent French and English literature, including clinical trials and reviews on LMWHs and their use in DVT. STUDY SELECTION: Trials comparing dalteparin, enoxaparin, tinzaparin, and nadroparin with UFH were selected. As studies were numerous, only randomized trials including more than 50 patients were reviewed. Moreover, all patients studied had a first episode of symptomatic DVT confirmed by objective tests (i.e., venography, duplex ultrasonography, impedance plethysmography). Clinical efficacy and safety of LMWHs were assessed in these trials. DATA EXTRACTION: Results pertaining to venographic assessment, recurrent thromboembolism, total mortality, and bleeding complications were extracted from the selected studies. DATA SYNTHESIS: Compared with UFH, LMWHs have a longer plasma half-life, better subcutaneous bioavailability, more predictable anticoagulant response, and require less intense laboratory monitoring. Most trials demonstrate comparable effects on thrombus extension and incidence of recurrent thromboembolism. Compared with UFH, LMWHs do not alter total mortality. Although animal trials predict a lower hemorrhagic potential for LMWHs, the incidence of bleeding complications is generally similar to that observed with UFH. Outpatient management of DVT with LMWHs has shown comparable safety and efficacy with inpatient UFH use but a shorter hospital stay. CONCLUSIONS: Because LMWHs are as safe and as effective as UFH, and because of their more convenient method of administration, they can be considered valuable alternatives for the treatment of DVT. Savings generated by less intensive laboratory monitoring and the possibility of early hospital discharge and outpatient therapy may outweigh the higher acquisition cost of LMWHs.

scholarly journals Prevalence of thromboembolic complications depending upon compliance and preventive care after endoprosthetics of large joints

2020 ◽  
pp. 46-48
Author(s):  
G. A. Palshin ◽  
S. S. Pavlov ◽  
M. Yu. Markovchina ◽  
A. N. Komissarov ◽  
P. V. Markov ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Deep Vein Thrombosis ◽  
Preventive Care ◽  
Lower Extremities ◽  
Low Molecular Weight ◽  
Thromboembolic Complications ◽  
Low Molecular Weight Heparins ◽  
Study Objective ◽  
Vein Thrombosis ◽  
Deep Vein

Objective. The study objective is to assess the efficacy of preventive care for thromboembolic complications after endoprosthetics of large joints depending on patients’ compliance.Methods: Prospective clinical examination of 686 patients aged 50–70 years, who underwent the endoprosthetics of knee and hip joints. Preventive care for thrombosis and embolism was performed according to three regimens: 1) monotherapy with parenteral low molecular weight heparins, 2) therapy with low molecular weight heparins converted to indirect anticoagulants, 3) administration of oral anticoagulants.Results: 376 patients (54.8%) fully complied with the medical recommendations. The rest 310 patients (45.2%), non-compliant patients, ignored medical prescriptions: refusal to take anticoagulants, spontaneous replacement of anticoagulants with antiplatelet agents, not taking medications as prescribed. Among compliant patients, deep vein thrombosis of lower extremities was registered in 9 cases (2.4%); among non-compliant patients, it was registered in 13 cases (4.2%).Conclusions: Deep vein thrombosis of lower extremities was registered significantly more often in non-compliant patients. To increase the efficacy of the prevention care for thromboembolic complications after endoprosthetics of large joints, more attention should be paid to explanatory work, explaining to patients the nature and negative consequences of compliance violations. 

Prophylaxis of thromboembolic complications in patients with hemorrhagic stroke

2017 ◽  
Author(s):  
С. Чуприна ◽  
Е. Шуленина
Keyword(s):  
Molecular Weight ◽  
Deep Vein Thrombosis ◽  
Hemorrhagic Stroke ◽  
Disease Onset ◽  
Lower Extremities ◽  
Low Molecular Weight ◽  
Thromboembolic Complications ◽  
Low Molecular Weight Heparins ◽  
Vein Thrombosis ◽  
Deep Vein

Введение. Одним из основных клинических факторов риска венозных тромбоэмболических осложнений (ВТЭО), не связанных с травмой и операцией, является инсульт и/или парез нижних конечностей. Однако для пациентов с геморрагическим инсультом до сих пор нет общепринятой эффективной и безопасной схемы профилактики ВТЭО. Цель исследования: оценка эффективности и безопасности профилактики тромбоза глубоких вен нижних конечностей и тромбоэмболии легочной артерии с помощью препарата Флюксум®. Материалы и методы. Обследовано 60 пациентов с геморрагическим инсультом: группа 1 (n = 30) – пациенты получали препарат парнапарин в дозе 0,3 мл подкожно 1 раз в сутки ежедневно, начиная со вторых суток от момента начала заболевания; группа 2 (n = 30) – пациенты получали другие низкомолекулярные гепарины в профилактических дозах также со вторых суток от момента начала геморрагического инсульта (эноксапарин в дозе 0,4 мл 1 раз в сутки, надропарин в дозе 0,3 мл 1 раз в сутки). Результаты. Показано, что у пациентов с геморрагическим инсультом использование нового низкомолекулярного гепарина – парнапарина (Флюксум®, Альфа Вассерманн, Италия) в дозе 0,3 мл подкожно 1 раз в сутки столь же эффективно для профилактики тромбоза глубоких вен, как и терапия другими низкомолекулярными гепаринами, при этом риск развития геморрагических осложнений не увеличивается. Заключение. Применение препарата Флюксум® может быть приемлемой альтернативой использованию других низкомолекулярных гепаринов для профилактики венозных тромбоэмболических осложнений у пациентов с геморрагическим инсультом. Introduction. Stroke and/or paresis of lower extremities are one of the main risks of vvenous thromboembolic complications (VTEC) not associated with trauma and surgery. At the same time, there is still no generally accepted effective and safe scheme of VTEC prophylaxis for patients with hemorrhagic stroke. The aim of study was to evaluate the efficacy and safety of prophylaxis of deep vein thrombosis of lower extremities and pulmonary embolism with drug Fluxum®. Materials and methods. We examined 60 patients with hemorrhagic stroke: group 1 (n = 30) – patients received Parnaparin at dose 0,3 ml subcutaneously once a day, starting from the second day after the disease onset; group 2 (n = 30) – patients received other low molecular weight heparins in prophylactic doses also from the second day after the onset of hemorrhagic stroke (Enoxaparin at dose 0,4 ml once a day, Nadroparin at dose 0,3 ml once a day). Results. It was shown that in patients with hemorrhagic stroke the usage of a new low molecular weight heparin – Parnaparin (Fluxum®, Alfa Wassermann, Italy) at dose of 0,3 ml subcutaneously once a day was equally effective for prophylaxis of deep vein thrombosis as therapy with other low-molecular heparins, and risk of hemorrhagic complications not increased. Conclusion. Fluxum® usage may be an acceptable alternative of other low molecular weight heparins usage for prevention of deep vein thrombosis in patients with hemorrhagic stroke.

Sign in / Sign up

Export Citation Format

Share Document