[Prophylactic antithrombotic therapy after orthopedic surgery with bemiparin, a second-generation low molecular weight heparin].

Objective: Bemiparin is a new second generation low molecular weight heparin with a molecular weight of 3,600 daltons and an anti-Xa/anti-IIa ratio greater than 8. The aim of this study was to evaluate the efficacy and safety of bemiparin administered at a daily dose of 3,500 IU anti-Xa (40 mg), with prophylaxis beginning 6 hours after total hip replacement surgery.

Patients And Methods: Fifty-seven consecutive patients were evaluated by bilateral phlebography of the lower limbs 10 days after surgery.

Venous thromboembolic prophylaxis in orthopedic surgery: knee surgery.

Knee replacement surgery is associated with a high risk of venous thromboembolic complications, and the risk appears to be highest during the 7 days following surgery. Meta-analysis of a number of randomized, controlled trials has conclusively established the efficacy and safety of low molecular weight heparin (LMWH) prophylaxis in knee replacement surgery. It is clear that LMWHs exhibit distinct physico-chemical, biological, and pharmacodynamic properties, and recently the United States Food and Drug Administration has concluded that these are noninterchangeable drugs.

Prevention of deep vein thrombosis after hip replacement--comparison between two low-molecular heparins, tinzaparin and enoxaparin.

Consecutive patients undergoing total hip replacement in 43 centres were randomly assigned to receive blindly either enoxaparin (40 mg) or tinzaparin (4,500 anti-Factor IU Xa), as once daily subcutaneous injections. The first injection was administered 12 h preoperatively. Efficacy was assessed by bilateral venography performed 12-14 days postoperatively.

Comparison of two low-molecular-weight heparins for the prevention of postoperative venous thromboembolism after elective hip surgery. Reviparin Study Group.

Low-molecular-weight heparins (LMWHs) have been shown to be effective in the prevention of deep vein thrombosis (DVT) after major orthopaedic surgery, such as total hip replacement (THR). The efficacy and safety of two LMWHs, reviparin and enoxaparin, were compared in a prospective, double-blind, double-dummy study involving 498 patients undergoing total hip replacement. Drugs were given preoperatively in doses of 4200 IU anti-Xa for reviparin and 40mg (approximately 4000 IU anti-Xa) for enoxaparin.

Cost effectiveness of a low-molecular-weight heparin in prolonged prophylaxis against deep vein thrombosis after total hip replacement.

The risk of late-occurring deep vein thrombosis and pulmonary embolism after total hip replacement persists for at least 3 weeks after hospital discharge. Recent clinical trials have demonstrated that prolonged prophylaxis with enoxaparin, a low-molecular-weight heparin (LMWH), significantly reduces this risk. We used a decision-analysis model to determine the incremental outcomes associated with the routine use of such prophylaxis, administered during hospitalisation for total hip replacement and for 3 weeks after discharge, instead of short term prophylaxis administered only during hospitalisation.

The post-hospital discharge venous thrombosis risk of the orthopedic patient.

ABSTRACTA prospective, randomized, double-blind trial was performed in total hip replacement patients to document the risk of deep vein thrombosis (DVT) after hospital discharge, and to assess the efficacy of sustained antithrombotic prophylaxis. In a total of 179 patients receiving enoxaparin 40 mg/day during hospitalization, those without venogram-proven DVT at discharge were randomly assigned to continue prophylaxis with enoxaparin (N=90) or receive placebo (N=89). At the end of 21 days' treatment, intention-to-treat analysis in 173 evaluable patients demonstrated a significantly lower incidence (P=0.

The post-hospital discharge venous thrombosis risk of the orthopedic patient.

A prospective, randomized, double-blind trial was performed in total hip replacement patients to document the risk of deep vein thrombosis (DVT) after hospital discharge, and to assess the efficacy of sustained antithrombotic prophylaxis. In a total of 179 patients receiving enoxaparin 40 mg/day during hospitalization, those without venogram-proven DVT at discharge were randomly assigned to continue prophylaxis with enoxaparin (N = 90) or receive placebo (N = 89). At the end of 21 days' treatment, intention-to-treat analysis in 173 evaluable patients demonstrated a significantly lower incidence (P = 0.

Risk of deep-venous thrombosis after hospital discharge in patients having undergone total hip replacement: double-blind randomised comparison of enoxaparin versus placebo.

Background: The risk of deep-vein thrombosis (DVT) and pulmonary embolism after total hip replacement (THR) surgery may persist after hospital discharge, but the extent of the risk is not known. We carried out a single-centre, prospective, randomised, double-blind trial with the aims of quantifying this risk and assessing the efficacy of continued prophylactic treatment.

Methods: At hospital discharge 13-15 days after surgery, we recruited 179 consecutive THR patients who had no DVT visible on bilateral ascending venography of the legs.

Efficacy and safety of postdischarge administration of enoxaparin in the prevention of deep venous thrombosis after total hip replacement. A prospective randomised double-blind placebo-controlled trial.

Although venous thromboembolism has occasionally been reported after hospital discharge in patients who have undergone total hip replacement (THR), this risk has not been fully quantified and the usefulness of a prophylactic treatment has not been evaluated. We conducted a single-centre prospective randomised double-blind clinical trial in 2 parallel groups of patients who had undergone THR and were free of deep venous thrombosis (DVT) at discharge, as assessed by bilateral ascending venography. During hospitalisation, all patients received a low molecular weight heparin, enoxaparin (enoxaparin sodium), as a prophylactic treatment for venous thromboembolism.

Prevention of deep vein thrombosis after total hip replacement. The effect of low-molecular-weight heparin with spinal and general anaesthesia.

Enoxaparin, a low-molecular-weight heparin, has been used together with spinal or general anaesthesia in a prospective, randomised study of 188 consecutive elective hip replacements. Bilateral venography was performed on all patients on day 13 after operation. Group I (65 patients) received spinal anaesthesia and no immediate injection of enoxaparin.

Efficacy and safety of a perioperative enoxaparin regimen in total hip replacement under various anesthesias.

Four trials in which enoxaparin, a low-molecular-weight heparin, was used in patients having hip surgery are reported. In the first two trials, enoxaparin was given before general anesthesia. The protocol consisted of 40 mg of enoxaparin, 4,000 anti-factor Xa IU, subcutaneously 12 hours before surgery, followed by the same dose 12 hours after surgery and then once daily.

[Prevention of deep vein thrombosis by enoxaparin after total hip prosthesis].

Once daily dosing of Enoxaparin to prevent deep vein thrombosis (DVT) after total hip replacement has been defined through two double-blind prospective, randomized multicentric trials. A previous prospective study including 228 consecutive patients had determined optimal dose to be 40 mg daily (4000 anti Xa U) begun 12 hours pre-operatively. The first trial (118 patients) compared two modes of administration of the dose of 40 mg--either 40 mg once daily or 20 mg twice daily, every twelve hours.

Total hip replacement and deep vein thrombosis. A venographic and necropsy study.

Bilateral venography was performed between 12 and 15 days after total hip replacement in 745 consecutive patients, all of whom had heparin prophylaxis. Of these, 81 patients (10.8%) showed evidence of recent deep vein thrombosis: 23 (3%) distal, 44 (5.

Once-daily dosing of enoxaparin (a low molecular weight heparin) in prevention of deep vein thrombosis after total hip replacement.

The main results of three successive prospective clinical trials which represent the successive steps in the definition of once-daily dosing of enoxaparin in elective hip surgery are demonstrated. In the first trial, a dose of 40 mg/day (4000 anti-Factor Xa IU), in one or two subcutaneous injections, was preferred to a dose of 60 mg because it gave the same efficacy with a better tolerance. In a second, randomized double-blind trial, the two modes of administration of a dose of 40 mg, in one or two injections daily, were found to be equivalent with regard to tolerance and efficacy.

The relationship between anti-factor Xa level and clinical outcome in patients receiving enoxaparine low molecular weight heparin to prevent deep vein thrombosis after hip replacement.

Studies in experimental animals have demonstrated that there is a relationship between levels of low molecular weight (LMW) heparin and both bleeding and inhibition of thrombosis. The relationship between these outcomes and ex vivo anti-factor Xa levels has been examined in 163 patients undergoing total hip replacement who were given prophylaxis once daily with a LMW heparin (enoxaparine). Fifty patients received 60 mg of enoxaparine and 113 received 40 mg, both regimens being administered subcutaneously once daily.

Prevention of postoperative venous thrombosis: a randomized trial comparing unfractionated heparin with low molecular weight heparin in patients undergoing total hip replacement.

A double blind randomized trial comparing subcutaneous enoxaparin (40 mg once daily) with standard unfractionated calcium heparin administered at a dose of 5,000 units every 8 hours in patients undergoing elective hip replacement has been performed. Treatment regimens began 12 hours preoperatively with enoxaparin, 2 hours preoperatively with standard unfractionated calcium heparin, and were continued for 15 days or until discharge. Venography was performed in all patients.

[Double-blind randomized comparative study of enoxaparin and standard heparin in the prevention of thromboembolic disease during insertion of total hip replacement].

237 patients with a non-traumatic disease of the hip requiring total hip replacement entered a multicentre trial. Treatments were allocated at random in a double-blind manner: 113 patients received 5000 IU of standard heparin t.d.

Enoxaparine low molecular weight heparin: its use in the prevention of deep venous thrombosis following total hip replacement.

Unlabelled: The effect of Enoxaparin in the prevention of thromboembolism after total hip prosthesis has been controlled by phlebography. 228 consecutives patients were studied with 4 dose regimens: 60 mg once a day, 40 mg once a day, and 30 and 20 mg twice a day.

Conclusions: a total dose of 40 mg once a day or twice a day gives a rate of postoperative thrombosis of 8%.

[Phlebography after total prosthesis. Action of subcutaneous sodium heparin in the prevention of thromboembolism. Results of therapeutic research with subcutaneous sodium heparin using 2 protocols in 250 patients monitored with phlebography].

Two series of patients on which total hip or knee prostheses had been inserted were studied. In the first series (150 cases), the patients were treated with low molecular Dextran and subcutaneous sodium heparin at a constant dosage. The Howell test was done every 3 days.