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Pharmacological thromboprophylaxis

R Fornaro, G Caristo, E Stratta, M Caratto, E Caratto, D Giovinazzo, L Di Maira, M Casaccia, M Frascio
Inflammatory bowel disease (IBD), Crohn's Disease (CD) and Ulcerative Colitis (UC) are associated with an increased risk of arterial and venous thromboembolism. A 2 to 3 time fold increased risk of developing thromboembolic complications was reported for IBD patients compared to general population. A systematic literature search was conducted using PubMed, Medline, Scopus, Cochrane database. The key words were: "Inflammatory Bowell Disease", "Crohn's Disease and Thrombosis", "Ulcerative Colitis and Thrombosis", "Thrombosis" and "Inflammatory Bowel Diseases and Thrombosis"...
January 2019: Il Giornale di Chirurgia
Emily Boyle, Julie Reid, Mark O'Donnell, Denis Harkin, Stephen Badger
BACKGROUND: Venous thromboembolism is rare following varicose vein ablation procedures, but uncertainty about its incidence combined with a lack of evidence-based clinical guidelines regarding thromboprophylaxis has led to debate about best practice. We conducted a national survey to investigate current practice among Irish vascular surgeons. METHODS: An anonymous online questionnaire was emailed to all members of the Irish Association of Vascular Surgeons and the Northern Ireland Vascular Society...
February 12, 2019: Phlebology
Siavash Piran, Sam Schulman
Patients with acute spinal cord injury (SCI) have the highest risk of venous thromboembolism (VTE) among hospitalized patients. The incidence of total deep vein thrombosis ranges from 50 to 100% in untreated patients and pulmonary embolism is the third most common cause of mortality in these patients. The pathophysiology of the increased risk of VTE is explained by venous stasis after injury, endothelial vessel wall injury from surgery, and a hypercoagulable state associated with trauma. The current thromboprophylaxis options are limited, with low-molecular-weight heparin (LMWH) being the current standard of care...
February 11, 2019: Seminars in Thrombosis and Hemostasis
Lauren E Amos, Michael Silvey, Matt Hall, Char M Witmer, Shannon L Carpenter
BACKGROUND/OBJECTIVES: Hospital acquired venous thromboembolism in children is associated with significant morbidity/mortality. Prevention strategies include sequential compression devices and prophylactic anticoagulation but these interventions carry risk and are poorly studied in children. Objectives were to evaluate primary thromboprophylaxis use in hospitalized children over time and the associated bleeding risk. MATERIALS AND METHODS: Retrospective study of hospitalized patients aged 10-18 years within the Pediatric Health Information System administrative database from January 2008-September 2015...
February 2, 2019: Thrombosis Research
Corinne Mirkazemi, Luke R Bereznicki, Gregory M Peterson
BACKGROUND: It is generally accepted that all arthroplasty patients should receive venous thromboembolism (VTE) and bleeding risk assessments, and that postoperative thromboprophylaxis be routinely prescribed where appropriate. Guideline recommendations regarding what to prescribe, however, have been inconsistent over the years, particularly regarding the appropriateness of aspirin. Our aim was to explore thromboprophylaxis patterns in use following hip and knee arthroplasty in Australia, and to examine associated variables...
February 8, 2019: BMC Musculoskeletal Disorders
Victor Waldmann, Mikael Laredo, Sylvia Abadir, Blandine Mondésert, Paul Khairy
A convergence of epidemiological and clinical features has prompted a precipitous rise in the prevalence of atrial fibrillation (AF) in the expanding population of adults with congenital heart disease. Herein, we synthesize the current state of knowledge on epidemiological features, associated morbidities, and pathophysiological insights regarding AF in adults with congenital heart disease. Management issues are examined including surgical, pharmacological, and catheter-based therapies. Throughout, knowledge gaps and avenues for future research are identified...
January 26, 2019: International Journal of Cardiology
B Pujic, N Holo-Djilvesi, Dj Djilvesi, C M Palmer
Epidural hematoma is a very uncommon complication of spinal anesthesia. Its incidence has been reported to be between 1:200 000-250 000 in the obstetric population following neuraxial anesthesia (D'Angelo et al., 2014). Cesarean delivery increases the risk of maternal venous thromboembolism significantly and recommendations to decrease its incidence and morbidity have been developed. Strategies to decrease venous thromboembolism include pharmacologic prophylaxis with unfractionated or low molecular weight heparin...
September 26, 2018: International Journal of Obstetric Anesthesia
Sylvia Haas
Low molecular weight heparins and fondaparinux have been the cornerstones for prevention of venous thromboembolism (VTE) in acutely ill medical patients for almost two decades. Guidelines recommend the use of these parenteral anticoagulants for 6 to 14 days but advise against extended-duration thromboprophylaxis after hospital discharge because no compelling scientific evidence has been provided for pharmacological prophylaxis beyond hospital stay. Five large randomized clinical trials, one with low molecular weight heparin and four with nonvitamin K antagonist oral anticoagulants, have failed to show significant clinically relevant benefit in this indication...
January 8, 2019: Hämostaseologie
Daniele Scarpa, Gentian Denas, Luciano Babuin, Vittorio Pengo
Patients admitted with acute medical conditions are at prolonged risk for venous thrombosis. The efficacy and safety, and the appropriate duration of thromboprophylaxis have not been clearly determined. In recent years, direct coagulation factor inhibitors have been successfully tested for the prevention and treatment of arterial and venous thromboembolism. Betrixaban is a novel direct inhibitor of factor Xa with a noteworthy pharmacological feature: limited renal clearance. Areas covered: This review focuses on the pharmacological profile of Betrixaban, including its clinical efficacy and safety...
February 2019: Expert Opinion on Pharmacotherapy
Aylin Durmaz Edeer, Saadet Comez, Hale Turhan Damar, Aysegul Savci
Objective: To investigate the prevalence of and risk factors for Venous Thromboembolism (VTE) in postoperative patients. Methods: This descriptive, cross-sectional, retrospective study was conducted from August 2016 to October 2016 at two university hospitals and one public hospital. Total 217,354 patients records who underwent surgery in between 2010 and 2015 were examined. The study sample consisted of 123 patients who had postoperative venous thrombosis and pulmonary embolism, and whose discharge details, consultation data, diagnostic reports, and tests were examined in detail...
November 2018: Pakistan Journal of Medical Sciences Quarterly
Kang-Il Kim, Dong-Kyoon Kim, Sang-Jun Song, Se-Jung Hong, Dae-Kyung Bae
INTRODUCTION: Purpose of this study was to assess whether the intermittent pneumatic compression (IPC) device would be an effective prophylaxis for deep vein thrombosis (DVT) following total knee arthroplasty (TKA) in a low incidence population. HYPOTHESIS: The mechanical thromboprophylaxis could reduce the incidence of DVT compared to non-prophylaxis group and would have similar efficacy as the chemoprophylaxis following TKA in a low DVT incidence population. MATERIALS AND METHODS: From January 2009 to June 2016, 1259 elective primary TKA with preoperative diagnosis of primary osteoarthritis in a single institute were enrolled...
December 13, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Rui Yang, Xia Zhao, Yilei Yang, Xin Huang, Hongjian Li, Lequn Su
OBJECTIVE: Our purpose is to evaluate the efficacy and safety of pharmacologic thromboprophylaxis following caesarean section (CS). METHODS: We searched PubMed, Embase, and the Cochrane Library. Then the systematic review was performed by analysing studies that met the eligibility criteria. RESULTS: Seven studies with 1243 participants were included, including 6 RCTs and 1 prospective cohort. Results from the meta-analysis showed that low molecular weight heparin (LMWH) was associated with no obvious decrease in the risk of thrombus compared with UHF and negative control...
2018: PloS One
Boriana Guimicheva, Jignesh P Patel, Lara N Roberts, Devi Subramanian, Roopen Arya
INTRODUCTION: Based on current guidelines, many women qualify for postnatal thromboprophylaxis following childbirth, however, little information exists on how adherent women are and their experiences to both pharmacological and mechanical forms of thromboprophylaxis. MATERIALS AND METHODS: Women requiring postnatal thromboprophylaxis were given questionnaire packs exploring their beliefs about enoxaparin, anti-embolic stockings (AES) and intermittent pneumatic compression devices (IPCD)...
November 22, 2018: Thrombosis Research
Gaisa T Kairov, Maksim A Solovev, Larisa Y Kotlovskaya, Vladimir V Udut
One of the crucial risk factors for development of severe postthrombotic disease (PTD) is the recurrence of deep vein thrombosis (DVT). New opportunities for pharmacological thromboprophylaxis of secondary thrombophilia were associated with the direct thrombin inhibitor-Dabigatran (Pradaxa; Boehringer Ingelheim, Germany). We aimed to investigate the daily pharmacodynamics of dabigatran in healthy volunteers and patients with PTD. Treatment with dabigatran in patients with PTD having chronic chronometric hypercoagulation and structural hypocoagulation before the administration of the drug is fraught with excessive anticoagulation and a high risk of clinically significant bleeding...
November 28, 2018: Clinical and Applied Thrombosis/hemostasis
Amna Ejaz, Munis M Ahmed, Azka Tasleem, Muhammad Rafay Khan Niazi, Muhammad Farhan Ahsraf, Imama Ahmad, Asma Zakir, Awais Raza
Thromboembolism is a major complication in hospitalized patients. Intensive care unit (ICU) patients have a greater risk of thrombotic events due to additional risk factors such as immobilization, mechanical ventilation, and central catheters. The diagnosis and management of deep vein thrombosis (DVT) and pulmonary embolism (PE) in critically ill patients are challenging and these conditions are associated with high mortality. Medical thromboprophylaxis with low molecular weight heparin (LMWH) as well as unfractionated heparin (UFH) has been shown to reduce the incidence of thromboembolic events in such patients...
September 21, 2018: Curēus
Muhammad Khan, Faisal Jehan, Terence O'Keeffe, Mohammad Hamidi, Narong Kulvatunyou, Andrew Tang, Lynn Gries, Bellal Joseph
BACKGROUND: Thromboprophylaxis with oral Xa inhibitors (Xa-Inh) are recommended after major orthopedic operation; however, its role in spine trauma is not well-defined. The aim of our study was to assess the impact of Xa-Inh in spinal trauma patients managed nonoperatively. METHODS: A 4-y (2013-2016) review of the Trauma Quality Improvement Program database. We included all patients with an isolated spine trauma (Spine-abbreviated injury scale ≥3 and other-abbreviated injury scale <3) who were managed nonoperatively and received thromboprophylaxis with either low molecular weight heparin (LMWH) or Xa-Inh...
December 2018: Journal of Surgical Research
Pelle Baggesgaard Petersen, Henrik Kehlet, Christoffer Calov Jørgensen
Most international guidelines recommend pharmacological thromboprophylaxis after total hip and knee arthroplasty (THA/TKA) for 10 to 35 days. However, a recent cohort study on fast-track THA and TKA questioned the need for prolonged thromboprophylaxis when length of stay (LOS) is ≤ 5 days. We aimed at re-investigating the incidence of venous thromboembolism (VTE) in fast-track THA and TKA with in-hospital only thromboprophylaxis when LOS was ≤ 5 days. Prospective cohort study from 1 December 2011 to 30 October 2015 on elective unilateral THA/TKA with in-hospital only thromboprophylaxis if LOS was ≤ 5 days...
December 2018: Thrombosis and Haemostasis
R Figueroa, A Alfonso, J López-Picazo, I Gil-Bazo, A García-Mouriz, J Hermida, J A Páramo, R Lecumberri
PURPOSE: Thromboprophylaxis use among medical inpatients, including cancer patients, is suboptimal. We aimed to evaluate the impact of a novel multiscreen version (v2.0) of an e-alert system for VTE prevention in hospitalised cancer medical patients compared to the original software. METHODS: Prospective study including 989 consecutive adult cancer patients with high-risk of VTE. Patients were followed-up 30 days post-discharge. Two periods were defined, according to the operative software...
November 16, 2018: Clinical & Translational Oncology
Yu-Chih Lin, Shen-Hsun Lee, I-Jung Chen, Chih-Hsiang Chang, Chee-Jen Chang, Yi-Chun Wang, Yuhan Chang, Pang-Hsin Hsieh
INTRODUCTION: This study evaluated the incidence of symptomatic pulmonary embolism (PE), subsequent mortality, risk factors, and the effects of pharmacological thromboprophylactic intervention following hip fracture surgery in Taiwan. MATERIALS AND METHODS: A nationwide study was conducted from February 2004 to September 2013. Hip fracture patients were placed into two groups: without symptomatic PE (control group) and with symptomatic PE (PE group). We analyzed the incidence of and risk factors for symptomatic PE, post-operative mortality rate, and effects of pharmacological thromboprophylactic intervention...
October 18, 2018: Thrombosis Research
Jeong-Ok Lee, Ji Yun Lee, Eun Ju Chun, Sang Il Choi, Jin Won Kim, Se Hyun Kim, Yu Jung Kim, Keun-Wook Lee, Jee Hyun Kim, Jong Seok Lee, Soo-Mee Bang
PURPOSE: The aim of this study was to estimate the incidence and predictors of venous thromboembolism (VTE) in medically ill hospitalized elderly cancer patients in a single Korean tertiary hospital. METHODS: Patients were examined for deep vein thrombosis (DVT) by duplex and color Doppler ultrasonography (DUS) of both legs between days 5 and 14 of their hospital stays. The primary endpoint was the incidence of VTE by day 14, which was determined via a composite of DVT detected by routine DUS and symptomatic VTE...
November 5, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
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