Outcomes of Anticoagulant Therapy with Low-Molecular-Weight Heparin (LMWH) and Warfarin for Thromboangiitis Obliterans (TAO)

2021 ◽  
Vol 19 ◽  
Author(s):  
Jiangping Gao ◽  
Liuhuan Huang ◽  
Jianli Wang
Keyword(s):  
Molecular Weight ◽  
Anticoagulant Therapy ◽  
Low Molecular Weight Heparin ◽  
Thromboangiitis Obliterans ◽  
Medium Size ◽  
Low Molecular Weight ◽  
Monocyte Count ◽  
Rest Pain ◽  
The Difference

Background: Thromboangiitis obliterans (TAO) is a chronic, non-atherosclerotic, progressive inflammatory vascular disease affecting the small- and medium-size arteries and veins of the extremities. Objective: To evaluate whether long-term anticoagulation with low-molecular-weight heparin (LMWH) and warfarin is beneficial for treating the inflammation and symptoms associated with TAO. Methods: Patients with TAO who underwent anticoagulation as the mainstay of treatment were included in this prospective study. Rest pain relief and healing of trophic lesions (as the primary and secondary endpoint) were investigated at day 14 and after 6 months of follow-up. High sensitivity C-reactive protein (hsCRP), monocyte count, and ankle-brachial index (ABI) were recorded and the difference compared before and after 2-week anticoagulation. The Chi-square test was used to compare the difference between anticoagulant and aspirin groups (based on the literature). Results: From 2014 to 2019, 18 patients were included. Only 1 patient with wet gangrene received endo-therapy for a failing stent at the start of treatment. After ~14 days, 12 of 13 (92%) patients showed complete ulcer healing and 17 of 18 (94%) patients showed complete relief from rest pain. Monocyte-counts and hsCRP levels decreased significantly (p<0.001) after a 2-week period of anticoagulation with LMWH. The mean follow-up was 2.6 years (range 0.5-5 years). At 6 months, all patients showed relief of rest pain and complete healing of trophic lesions. All endpoints were significantly improved compared with the aspirin group (p<0.01), and no rest pain or ulcer/gangrene recurred during follow-up. Conclusion: Anticoagulant therapy may alleviate the inflammation and symptoms of TAO.

Rezidivierende isolierte Unterschenkelmuskelvenenthrombose bei Soleusvenenaneurysma

VASA ◽  
2002 ◽  
Vol 31 (4) ◽  
pp. 277-279 ◽  
Author(s):  
Schwarz ◽  
Zimmermann ◽  
Hänig ◽  
Schröder ◽  
Schellong
Keyword(s):  
Molecular Weight ◽  
Low Molecular Weight Heparin ◽  
Rare Case ◽  
Calf Muscle ◽  
Venous Aneurysm ◽  
Low Molecular Weight ◽  
Therapeutic Dosage ◽  
Follow Up Study ◽  
Short Course

A rare case of venous aneurysm involving the soleal muscle vein in an 18-year-old woman is presented. The patient showed three episodes of ultrasonographically proven calf muscle thrombosis within 2 years. After a short course of low-molecular-weight heparin at a therapeutic dosage, complete thrombus recanalization was achieved. To prevent further thrombotic episodes, surgery including ligation and resection of the aneurysm was performed. At the 3-month follow-up study the patient had completely recovered.

EVALUATION OF POSTEXODONTIC BLEEDING IN PATIENTS RECEIVING ANTICOAGULANT THERAPY WITH LOW-MOLECULAR-WEIGHT HEPARIN: PILOT STUDY

2020 ◽  
Vol 130 (3) ◽  
pp. e248
Author(s):  
GIOVANA BADAN MARTINS ◽  
ANA ELIZA DURãES DE FARIA ◽  
AMANDA KIMURA LUCCHESI REIS ◽  
MARCUS VINíCIUS BUENO ◽  
MARIA PAULA SIQUEIRA DE MELO PERES ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Pilot Study ◽  
Anticoagulant Therapy ◽  
Low Molecular Weight Heparin ◽  
Low Molecular Weight

Thrombocytopenia Is More Common and Nadir Occurs Earlier with Unfractionated Heparin Than with Low Molecular Weight Heparin - Results from the Prospective Catch Registry.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2197-2197
Author(s):  
Stephan Moll ◽  
Charles S. Abrams ◽  
Lawrence Rice ◽  
Richard C. Becker ◽  
Peter B. Berger ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Platelet Count ◽  
Unfractionated Heparin ◽  
Low Molecular Weight Heparin ◽  
Heparin Therapy ◽  
P Value ◽  
Low Molecular Weight ◽  
Life Threatening ◽  
The Difference ◽  
Time To Onset

Abstract Background : Thrombocytopenia in the patient on heparin can have various etiologies, including benign reversible causes and serious, potentially life-threatening ones, such as heparin induced thrombocytopenia (HIT). Knowledge about the prevalence of and timecourse of thrombocytopenia in heparin-treated patients may be helpful to develop systems of alerting clinicians to possible HIT and determining how frequently to check blood counts to detect thrombocytopenia that may be heralding HIT. Methods : The CATCH registry is a prospective registry of inpatients enrolled between March 2003 and April 2004 at over 50 US hospitals in 3 strata: [1] receiving > 96 hours of unfractionated heparin (UFH) or low molecular weight heparin (LMWH), [2] developing thrombocytopenia (platelets >50% reduction from baseline or <150,000/mm3) in the cardiac care unit and [3] patients on whom HIT tests were ordered. Here we present the data of the prolonged heparin stratum. Results : 1,121 and 861 patients received UFH and LMWH, respectively, for > 96 hours. A platelet count decrease of > 50 % from baseline was seen more frequently in patients on UFH than in patients on LMWH (10.7% and 7.9 %, respectively; p = 0.03). The parameters that predicted development of thrombocytopenia in the UHF group were length of heparin therapy, body mass index, and admission to a cardiac service; the only parameter predicting thrombocytopenia in the LMWH group was length of LMWH treatment. Of the patients with decreased platelet count by > 50 % from baseline (for UFH n = 120; for LMWH n = 68), this drop occurred in the UFH group at a median of 3.0 days after initiation of heparin and at a median of 4.0 days in the LMWH group. The difference in timing between the 2 groups was not statistically significant (p = 0.205). The platelet nadir was reached after a median /mean of 4.0 / 7.4 days in the UFH group, and 8.0 / 11.4 days in the LMWH group. This was statistically significantly different between the 2 groups (p-value = 0.0025). Conclusions : A platelet count decrease of > 50 % from baseline occurs frequently in inpatients treated with prolonged heparin. It occurs slightly more frequently on UFH than on LMWH. The median time to onset of thrombocytopenia (> 50 % decrease from baseline) occurs early, at 3–4 days. Daily platelet count checks in the first few days of heparin therapy may be helpful to rapidly discover thrombocytopenia that may then prompt HIT testing.

A retrospective single-center evaluation of the safety and efficacy of direct oral anticoagulants versus low molecular weight heparin in patients with cancer-associated thrombosis.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24102-e24102
Author(s):  
Melissa McShane ◽  
Jordan Senchak ◽  
Anthony Stack ◽  
Justina Frimpong ◽  
Van T Hellerslia ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Major Bleeding ◽  
Low Molecular Weight Heparin ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Low Molecular Weight ◽  
Safety And Efficacy ◽  
The Past ◽  
Cancer Associated Thrombosis

e24102 Background: Over the past decade, there has been an increase in the use of direct oral anticoagulants (DOACs) in the cancer population despite limited data comparing its use against low molecular weight heparin (LMWH), the standard of care in cancer patients. Increasing data supporting DOACs in cancer-associated thrombosis has emerged over the past few years. Nonetheless, this study will evaluate the relative safety and efficacy of DOACs versus LMWH in cancer-associated thrombosis within an urban setting associated with low socioeconomic status. Methods: This is a retrospective chart review of medical records from patients treated at an urban academic medical center from October 2010 through October 2018. Patients met study inclusion if they had a diagnosis of venous thromboembolism occurring after the date of diagnosis of active cancer and were prescribed a direct oral anticoagulant (rivaroxaban, apixaban, dabigatran, edoxaban) or a low molecular weight heparin (dalteparin, enoxaparin, or fondaparinux) as monotherapy for the treatment of venous thromboembolic disease. Patients were excluded if they had less than 6 months of follow up data for reasons other than death. The primary outcomes were recurrent venous thromboembolism, major bleeding and death. Results: Of the 914 patients who met inclusion criteria, 286 were excluded due to lack of follow up data. The remaining patients included 472 in the LMWH arm and 156 in the DOAC arm. At 6 months, recurrent thromboembolism occurred in 5 of the 472 patients (1.1%) in the LMWH group as compared with 4 of the 156 patients (2.6%) in the DOAC group (p = 0.170). Major bleeding occurred in 36 patients (7.6%) in the LMWH group and 11 patients (7.0%) in the DOAC group (p = 0.813). Death within 6 months of starting anticoagulation occurred in 76 patients (16.1%) in the LMWH group and 16 patients (9.6%) in the DOAC group (p = 0.046). Discontinuation before 6 months of treatment occurred in 241 patients (51.2%) in the LMWH group and 46 patients (29.5%) in the DOAC group. Conclusions: The LMWH and DOAC groups had similar rates of recurrent thromboembolism and major bleeding. The mortality rate within 6 months of starting anticoagulation was significantly higher in the LMWH group and this difference requires further evaluation. These results help support the continued use of DOACs for the treatment of cancer-associated thrombosis and demonstrate that DOACs are as safe and effective as LMWH in this patient population.

scholarly journals Evaluation of a Dose-Monitoring Method for Prophylactic Anticoagulant Therapy with Low-Molecular-Weight Heparin

2011 ◽  
Vol 02 (04) ◽  
pp. 429-434
Author(s):  
Shintaro Makino ◽  
Motoi Sugimura ◽  
Takashi Yorifuji ◽  
Taro Koshiishi ◽  
Toshitaka Tanaka ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Anticoagulant Therapy ◽  
Low Molecular Weight Heparin ◽  
Low Molecular Weight ◽  
Monitoring Method ◽  
Dose Monitoring

scholarly journals Analysis of Age and Prevention Strategy on Outcome after Cerebral Venous Thrombosis

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Xiuli Chu ◽  
Jianlin Zhang ◽  
Bin Zhang ◽  
Yuwu Zhao
Keyword(s):  
Molecular Weight ◽  
Functional Outcome ◽  
Neurological Deficit ◽  
Low Molecular Weight Heparin ◽  
Thrombotic Event ◽  
Prevention Strategy ◽  
Low Molecular Weight ◽  
Neck Infection ◽  
Presenting Symptoms

Object. Cerebral venous sinus thrombosis (CVST) mainly affects middle-aged individuals. However, the association between age or prevention strategy with the functional outcome remains poorly investigated. Method. We identified adult CVST patients in our centers. Functional outcome and prevention strategy were extracted from medical records. Modified Rankin Scale mRS ≤ 1 is considered a good functional outcome. Results. A total of 113 patients were identified. The most common presenting symptoms were headache (86.72%) and nausea/vomiting (56.63%); the top two identified risk factors were local head/neck infection (27.43%) and pregnancy/puerperal period (19.47%). The medical encounter lag time was 0.04 d-120 d. Four enrolled patients were diagnosed as CVST again, and the interval time was 3-8 years from the first time. Thrombus was most frequently seen at superior sagittal sinus (53.10%) and sigmoid sinus (50.44%). 94 (83.19%) of the patients had good outcomes. In the acute phase, 91 (80.53%) patients received low molecular weight heparin, 29 (25.66%) took aspirin, 7 (6.19%) patients were put on low molecular weight heparin and aspirin together. During our follow up (6-24 m), there were 10 (8.85%) patients who suffered from thrombotic event recurrence. For the patients > 40 years old, they tended to suffer from neurological deficit (25.00%) and stupor/coma (16.67%) ( p > 0.05 ), with a higher rate of hemorrhage (20.83%) and death (4.16%) when compared with the younger patients (10.77% and 1.53%, separately) ( p > 0.05 ). Conclusion. Functional outcome after CVST appears good. For the patients over 40-year-old, neurological deficit and altered consciousness were more common, accompanied by a higher rate of hemorrhage and mortality. The recurrent rate of CVST was low, longer-term follow up needed. The prevention strategy after CVST was uncertain, further studies needed.

Subcutaneous Low Molecular Weight Heparin versus Subcutaneous Unfractionated Heparin in the Treatment of Deep Vein Thrombosis: a Polish Multicenter Trial

1992 ◽  
Vol 68 (01) ◽  
pp. 014-018 ◽  
Author(s):  
S Lopaciuk ◽  
A J Meissner ◽  
S Filipecki ◽  
K Zawilska ◽  
J Sowier ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Deep Vein Thrombosis ◽  
Unfractionated Heparin ◽  
Low Molecular Weight Heparin ◽  
Multicenter Trial ◽  
Fixed Dose ◽  
Low Molecular Weight ◽  
Vein Thrombosis ◽  
The Difference ◽  
Deep Vein

SummaryIn a prospective multicenter trial, 149 consecutive patients with phlebographically proven proximal and/or distal deep vein thrombosis of the leg were randomly allocated to receive subcutaneously for 10 days either low molecular weight heparin CY 216 (Fraxiparine) in a fixed dose or unfractionated heparin (UFH) in doses adjusted according to the activated partial thromboplastin time. Pre- and post-treatment phlebograms were assessed blindly using the Arnesen’s score system in 134 patients available for analysis of the treatment efficacy. The mean phlebographic score after 10 days of treatment was significantly decreased in both groups (p <0.001) in comparison with the baseline score but the difference in score changes between the two groups was not statistically significant. There was an improvement in 45/ 68 patients (66%) in the Fraxiparine group and in 32/66 patients (48%) in the UFH group, and an increase in the thrombus size in 10/68 (15%) and 12/66 (18%), respectively. One symptomatic non-fatal pulmonary embolism and one major bleeding episode were observed in the UFH group. During a follow-up period of 3 months, two rethromboses had occurred in the UFH group and none in the Fraxiparine group. It is concluded that subcutaneous fixed dose Fraxiparine is safe and at least as effective as subcutaneous adjusted UFH in the treatment of deep vein thrombosis.

Bridging with enoxaparin using a half-therapeutic dose regimen: safety and efficacy

VASA ◽  
2010 ◽  
Vol 39 (3) ◽  
pp. 243-248 ◽  
Author(s):  
Klamroth ◽  
Gottstein ◽  
Essers ◽  
Landgraf
Keyword(s):  
Molecular Weight ◽  
Anticoagulant Therapy ◽  
Therapeutic Dose ◽  
Oral Anticoagulant ◽  
Low Molecular Weight Heparin ◽  
Oral Anticoagulant Therapy ◽  
Major Surgery ◽  
Low Molecular Weight ◽  
Severe Bleeding ◽  
Thromboembolic Risk

Background: Low molecular weight heparin is widely used during the interruption of long-term oral anticoagulation in patients undergoing surgery. The optimal dose is still a matter of debate. The 8th ACCP Guidelines primarily recommend therapeutic-dose or low-dose low molecular weight heparin after stratification of the thromboembolic risk. We investigated the efficacy and safety of a standardized bridging therapy with enoxaparin in a half-therapeutic dose in patients with a target INR of 2,0 to 3,0. Patients and methods: In our prospective registry we studied 198 consecutive patients receiving oral anticoagulant therapy with phenprocuomon and a planned surgery. Phenprocoumon was stopped 7 days before surgery and after reaching an INR less than 2,0 all patients received enoxaparin in a half-therapeutic dose (1 × 1 mg / kg body weight (bw)/day) until the day before surgery. Enoxaparin was continued with the same dose split into 2 × 0,5 mg / kg bw / day after the procedure. Phenprocoumon was resumed within day 1 to 14 after surgery depending on the bleeding risk as determined by the surgeon. All patients were followed up for 28 days after surgery. Results: Major surgery was performed in 148 patients (75 %). 175 patients (88 % of the total) had an intermediate thromboembolic risk. On average, enoxaparin was administered for 19,5 days. One patient (0,5 %) experienced arterial thrombosis after surgery, and one patient (0,5 %) required a second surgical intervention due to severe bleeding. Conclusions: In patients receiving oral anticoagulant therapy with a target INR of 2,0-3,0 and at an intermediate risk of thromboembolic events who require interruption of oral anticoagulant therapy a half therapeutic dose of enoxaparin seems to be safe and effective for bridging.

Sign in / Sign up

Export Citation Format

Share Document