Prevention of postoperative deep vein thrombosis in cancer patients. A randomized trial with low molecular weight heparin (CY 216).
Sixty-one consecutive patients were enrolled in a randomized, controlled trial of thromboprophylaxis with a low molecular weight heparin (Seleparina, CY 216) in major abdominal oncological surgery. Thirty patients received 2 x 3,825 anti-Xa international units of CY 216 subcutaneously on the day of surgery followed by a single daily 3,825 anti-Xa international units injection for 7 days; thirty-one patients did not receive any form of prophylaxis. The occurrence of deep vein thrombosis (DVT) was detected by 125I-labelled fibrinogen leg scan. Postoperative DVT developed in 2 patients in the CY 216 group and in 11 patients in the control group (6.8% vs 35.4%, p < 0.01). Although there was a higher postoperative transfusional requirement in the group receiving CY216 (p < 0.05), the total number of patients transfused was similar in the two groups (14 vs 13). On day 1 after surgery, the two patients who later developed DVT in the CY216 group had plasma anti-Xa activity significantly lower (p < 0.01) than the remaining patients. As a good relationship was found between plasma anti-Xa activity and body weight, adoption of a personalized dosage schedule might improve efficacy of CY 216 prophylaxis.
2nd Department of Surgery, IRCCS H. S. Raffaele, Milan, Italy.
A
A
Marassi
G
G
Balzano
G
G
Mari
S V
SV
D'Angelo
P
P
Della Valle
V
V
Di Carlo
A
A
D'Angelo
D000005:Abdomen / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D004361:Drug Tolerance; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D016018:Least-Squares Analysis; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000150:complications* / Q000601:surgery; D011183:Postoperative Complications / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control*; D011446:Prospective Studies; D013924:Thrombophlebitis / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control*
D006495:Heparin, Low-Molecular-Weight