[Out-patient treatment of deep vein thrombosis: management and experience of two vascular care centres in Germany].
OBJECTIVE
In Germany there are still major reservations about using low molecular weight heparin for the treatment of deep vein thrombosis. Based on encouraging international reports, we have been establishing a primarily out-patient management of thrombosis since 1996. In our centres for vascular diseases we tried to evaluate the suitability of such a regimen for the treatment of patients in Germany.


METHODS
Between January 1996 and October 1999 we evaluated the possibility of an out-patient therapy for all patients with acute deep vein thrombosis who had been referred to our institution. Suitable patients were treated with an initial daily dose of 200 IU Dalteparin per kg body-weight in addition to compression therapy.


RESULTS
During this time we treated 587 patients with deep vein thrombosis of the lower extremities (41 % men and 59 % woman with a mean age of 60.3 +/- 13.8 years) of whom 105 were hospitalised. Out-patient therapy was without any complications in 94.2 % of the remaining 482 patients. Overall mortality was 0.4 % (2 patients). The deaths occurred without apparent relationship to the kind of therapy. Progressive thrombus extension occurred in five patients, symptomatic pulmonary embolism in one patient and >>recurrent thromboembolic events<< in nine patients. These results correspond with the good efficacy of Dalteparin as expected from the data in the literature. Severe bleedings were not observed. Three patients experienced mild bleeding.


CONCLUSIONS
We conclude from our data that, in accordance with international studies, an out-patient thrombosis management with Dalteparin is efficacious and safe.
Offermann
M
M
Gemeinschaftspraxis für Gefässkrankheiten, Essen. offermann@vascular.de
Koepchen
J
J
Graulich
B
B
D000208:Acute Disease; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D017985:Dalteparin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D010690:Phlebography; D013924:Thrombophlebitis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D013997:Time Factors
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D017985:Dalteparin
Die ambulante Therapie der akuten tiefen Beinvenenthrombose - Erfahrungen aus zwei Praxen für Gefässkrankheiten in Deutschland -