Unexpectedly high rate of phlebographic deep venous thrombosis following elective general abdominal surgery among patients given prophylaxis with low-molecular-weight heparin.
One hundred ninety-four patients undergoing elective general abdominal surgery were randomized in a single-blind study to receive one daily subcutaneous injection of a low-molecular-weight heparin, dalteparin sodium (2500 IU, n = 97) or nadroparin calcium (3075 IU, n = 97), two regimens that are approved in Europe to prevent deep venous thrombosis. On the eight postoperative day, bilateral ascending leg phlebography (n = 185) showed the presence of deep venous thrombosis in 45 cases (24.3%; 95% confidence interval, 18% to 31%), with a significantly higher rate (on intention-to-treat) among the patients who received the lower dosage (30 vs 15 deep venous thromboses). We conclude that the two regimens of low-molecular-weight heparin that were used in this study failed to prevent postoperative phlebographically proved deep venous thrombosis in one of four patients.
Bounameaux
H
H
Department of Medicine, University Hospital of Geneva, Switzerland.
Huber
O
O
Khabiri
E
E
Schneider
P A
PA
Didier
D
D
Rohner
A
A
D000005:Abdomen / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000933:Antifibrinolytic Agents / Q000097:blood; D001458:Bandages; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D013817:Thermography / Q000379:methods; D013924:Thrombophlebitis / Q000209:etiology* / Q000517:prevention & control
D000933:Antifibrinolytic Agents; D005338:Fibrin Fibrinogen Degradation Products; D006495:Heparin, Low-Molecular-Weight; C036309:fibrin fragment D