Post-surgical deep vein thrombosis prevention: evaluation of the risk/benefit ratio of fractionated and unfractionated heparin.
An open controlled study was carried out to assess the efficacy and tolerance of a new low molecular weight heparin for the prevention of post-surgical deep vein thrombosis and pulmonary embolism. Forty-five patients undergoing abdominal surgery mainly for neoplasm, gallstones and gastric ulcers were administered 7,500 AXaU of low molecular weight heparin subcutaneously, 2 hours before surgery and once a day for 7 days after. Heparin calcium (15,000 IU subcutaneously per day) was used as a comparison drug in 45 control subjects, matched for age, sex and type of operation. Deep vein thrombosis was identified with clinical parameters, radio-labelled fibrinogen uptake test, echo-doppler and venography; pulmonary embolism with clinical examination, chest X-rays and/or scintigraphy. No episodes of deep vein thrombosis occurred in the low molecular weight heparin-treated patients, whilst there was 1 episode, without pulmonary embolism, in the control group. The consumption of blood and haemoderivatives for transfusions was higher in the heparin calcium group. Only in this group, furthermore, did 5 patients have to suspend antithrombotic treatment due to severe haemorrhages. General tolerance of the two drugs was identical and very good.
Garcea
D
D
A Department, Ospedale Maggiore C.A. Pizzardi, Bologna, Italy.
Martuzzi
F
F
Santelmo
N
N
Savoia
M
M
Casertano
M G
MG
Furno
A
A
Ruggeri
V
V
D000368:Aged; D002769:Cholelithiasis / Q000601:surgery; D005069:Evaluation Studies as Topic; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006493:Heparin / Q000009:adverse effects / Q000627:therapeutic use*; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000601:surgery; D016017:Odds Ratio; D010314:Partial Thromboplastin Time; D011183:Postoperative Complications / Q000097:blood / Q000517:prevention & control*; D012307:Risk Factors; D013924:Thrombophlebitis / Q000517:prevention & control*
D006495:Heparin, Low-Molecular-Weight; D006493:Heparin