Rivaroxaban and dabigatran etexilate: two new oral anticoagulants for extended postoperative prevention of venous thromboembolism after elective total hip arthroplasty

2009 ◽  
Vol 130 (5) ◽  
pp. 583-589 ◽  
Author(s):  
Lars C. Borris
2018 ◽  
Vol 26 (2) ◽  
pp. 86-90
Author(s):  
RAUL CARNEIRO LINS ◽  
EPITÁCIO LEITE ROLIM FILHO ◽  
FERNANDO DE SANTA CRUZ OLIVEIRA ◽  
SAULO MONTEIRO DOS SANTOS ◽  
TALE LUCAS VIEIRA ROLIM ◽  
...  

ABSTRACT Objectives: To evaluate the effectiveness of aspirin as prophylaxis for deep venous thrombosis (DVT) in patients undergoing total hip arthroplasty (THA), and to analyze the incidence of bleeding during the post-operative period. Methods: This prospective study carried out in 2017 consisted of 37 patients indicated for THA with high risk for DVT. Immediately after the procedure, aspirin, elastic compression socks and early deambulation were initiated. Doppler ultrasound was performed in the legs 6 days and 6 weeks post-procedure to rule out venous thromboembolism. Hematometric variables and clinical criteria were used to detect bleeding. Results: The incidence of VTE (venous thromboembolism) 6 days post-procedure was 21.6%. By 6 weeks post-procedure, it dropped to 8.1%, (p = 0.102). Only 2.7% were diagnosed with VTE, 6 days and also 6 weeks post-procedure. Within the immediate postoperative period, hemoglobin was lower (p < 0.001), in contrast to 6 weeks after surgery, when it returned to baseline levels. Conclusion: Aspirin was an effective chemical prophylaxis for venous thromboembolism in high-risk patients who underwent THA. There was no clinical record of postoperative bleeding and hematometric levels suggested that there was no chronic bleeding. Level of Evidence II; Prospective study.


2011 ◽  
Vol 18 (2) ◽  
pp. 67-70 ◽  
Author(s):  
Andrey Pavlovich Momot ◽  
I V Merkulov ◽  
E V Grigor'eva ◽  
M Yu Panov ◽  
A P Momot ◽  
...  

Comparative assessment of the efficacy and safety of enoxaparin and dabigatran thromboprophylaxis after total hip arthroplasty was performed. Hemorrhagic and thrombotic complications as well as indices of laboratory tests after application of new oral thrombin inhibitor Dabigatran Etexilate were taken into account. Study included 161 patients who were randomized into two groups and operated on under spinal anesthesia. First group (81 patients) was on subcutaneous enoxaparin (40 mg/day), second group (80) was on dagibartan (200 mg/day). The day before surgery and on 5th and 10th days after arthroplasty duplex angioscanning of lower extremities and assessment of blood clotting parameters was performed. It was shown that in case of significant intraoperative blood loss thromboprophylaxis with both enoxaparin and dabigatran was similar to that with low-molecular-weight heparin. Postoperative thrombogenic risk by D-dimers level was higher with enoxaparin versus dabigatran application. Peroral use of anticoagulants is more acceptable due to its noninvasiveness, safety, low requirements in laboratory monitoring and convenience of application in out-patient conditions. In patients with low compliance testing of blood plasma thrombin can be used for the confirmation of dabigatran intake when necessary.


2020 ◽  
Vol 28 (2) ◽  
pp. 230949902093886
Author(s):  
Wael A. Rahman ◽  
Gamal H Habsa ◽  
Omar A. Al-Mohrej ◽  
Mohammed Hammad ◽  
Naser M. Selim ◽  
...  

Propose: Total hip arthroplasty (THA) is associated with a significant risk of venous thromboembolism (VTE). Different thromboprophylaxis strategies have been used to prevent VTE. The primary aim of this study was to report the incidence of VTE and compare the efficacy and safety of rivaroxaban to enoxaparin. The secondary outcome was to report the incidence of silent deep venous thrombosis (DVT) using computed tomography venography. Methods: One hundred sixty patients who underwent THA were enrolled in a prospective study. Patients were randomized into two groups as follows: those who received rivaroxaban 10 mg oral daily (group RXE) and those who received enoxaparin 40 IU/day subcutaneously for 14 days (group ENO). Results: Both groups were matched for age, sex, comorbidities, special habits and preoperative laboratory investigations. The overall incidence of DVT was 5% ( n = 8), which included four patients clinically diagnosed as having DVT and four with silent DVT. All the DVT cases occurred in veins below the knee and in the group RXE; none of the cases occurred in group ENO ( p = 0.04). The incidence of DVT was significantly higher in patients with high body mass indexes ( p < 0.001), older age ( p = 0.024) and medical comorbidities ( p = 0.14). No mortality, pulmonary embolism, stroke, wound infection or major bleeding occurred in either group. Conclusions: Among the patients who underwent hip arthroplasty, rivaroxaban prophylaxis was found to be associated with lower efficacy and similar safety outcomes as compared with enoxaparin anticoagulants.


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