title: Comparison of the use of enoxaparin versus unfractionated heparin in patients undergoing lower extremity revascularization.
abstract: Present available studies suggest that heparin prevents early vessel thrombosis in the immediate postoperative (POP) period after lower extremity bypass. Long-term anticoagulation with warfarin has also been used in these patients, based on its beneficial effect in preventing long-term graft failure. To compare the effectiveness between unfractionated heparin (UH) and low-molecular-weight heparin (enoxaparin) when used as transitional therapeutic POP anticoagulant therapy, a prospective study was performed. Seventy consecutive patients undergoing lower extremity bypass were studied. The initial 35 patients were started on a drip of UH 6 hours POP. The next 35 consecutive patients were treated with enoxaparin, the first dose starting 6 hours POP. All patients underwent subsequent anticoagulation with oral warfarin. There were no statistically significant differences between the two groups with regard to demographics, percentage of above/below the knee bypasses, type of conduit used, emergency operations, and overall complications. There was a significant difference in the length of stay (p = 0.05) in favor of the enoxaparin group, which also reflected a decreased overall cost in this group. In conclusion, POP anticoagulation with enoxaparin is as safe end effective as UH in patients undergoing lower extremity revascularization. Enoxaparin was associated with a decreased overall length of stay and hospital costs.
authors.affiliation: Department of Surgery, Mount Sinai Medical Center, Miami Beach, FL 33140, USA.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Paramo
authors.forename: Harry
authors.initials: H
authors.lastname: Sendzischew
authors.forename: Manuel
authors.initials: M
authors.lastname: Sivina
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000191:economics / Q000627:therapeutic use*; D019917:Blood Vessel Prosthesis Implantation; D003365:Costs and Cost Analysis; D017984:Enoxaparin / Q000191:economics / Q000627:therapeutic use*; D005260:Female; D006493:Heparin / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin; D006493:Heparin