New ways to prevent venous thromboembolism--the pentasaccharide fondaparinux and the thrombin inhibitor ximelagatran--a review.
During the last decade low molecular weight heparins have been the dominating methodology to prevent postoperative venous thromboembolism. They are effective and safe but in high risk surgery (major orthopaedic and abdominal/pelvic cancer) there is still a significant thrombotic problem. Recently two new thromboprophylactic principles have appeared--one Xa inhibitor in the form of the pentasaccharide fondaparinux and one direct thrombin inhibitor in the form of melagatran with an orally absorbable prodrug--ximelagatran. Both have been evaluated in extensive research programmes and both have been approved for use in major orthopaedic surgery by the European health care authorities.
Bergqvist
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University Hospital, Department of Surgery, Uppsala, Sweden. david.bergqvist@surgsci.uu.se
D000925:Anticoagulants / Q000627:therapeutic use*; D001384:Azetidines / Q000627:therapeutic use*; D001596:Benzylamines; D000077425:Fondaparinux; D006801:Humans; D011134:Polysaccharides / Q000627:therapeutic use*; D013923:Thromboembolism / Q000517:prevention & control*
D000925:Anticoagulants; D001384:Azetidines; D001596:Benzylamines; D011134:Polysaccharides; C426686:ximelagatran; D000077425:Fondaparinux