A Comparison of Low-Dose Heparin with Low-Molecular-Weight Heparin as Prophylaxis against Venous Thromboembolism after Major Trauma

Geerts, William; Jay, Richard; Code, Karen I.; Chen, Erluo; Szalai, John Paul; Saibil, Eric A.; Hamilton, Paul

doi:10.1056/nejm199609053351003

Cited by 759 publications

(553 citation statements)

References 40 publications

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“…The risk of developing pulmonary embolism (PE) is present in as many as 25% of patients if inadequately treated (2). With the development of retrievable (optional) inferior vena cava (IVC) filters, placement of these devices for the prevention of VTE complications has become increasingly popular, and has resulted in a dramatic surge in the placement rate (3).…”

Section: Introductionmentioning

confidence: 99%

Inferior vena cava filter retrievals, standard and novel techniques

Kuyumcu¹,

Walker²

2016

Cardiovasc. Diagn. Ther.

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Abstract:The placement of an inferior vena cava (IVC) filter is a well-established management strategy for patients with venous thromboembolism (VTE) disease in whom anticoagulant therapy is either contraindicated or has failed. IVC filters may also be placed for VTE prophylaxis in certain circumstances.There has been a tremendous growth in placement of retrievable IVC filters in the past decade yet the majority of the devices are not removed. Unretrieved IVC filters have several well-known complications that increase in frequency as the filter dwell time increases. These complications include caval wall penetration, filter fracture or migration, caval thrombosis and an increased risk for lower extremity deep vein thrombosis (DVT). Difficulty is sometimes encountered when attempting to retrieve indwelling filters, mainly because of either abnormal filter positioning or endothelization of filter components that are in contact with the IVC wall, thereby causing the filter to become embedded. The length of time that a filter remains indwelling also impacts the retrieval rate, as increased dwell times are associated with more difficult retrievals. Several techniques for difficult retrievals have been described in the medical literature. These techniques range from modifications of standard retrieval techniques to much more complex interventions. Complications related to complex retrievals are more common than those associated with standard retrieval techniques. The risks of complex filter retrievals should be compared with those of life-long anticoagulation associated with an unretrieved filter, and should be individualized. This article summarizes current techniques for IVC filter retrieval from a clinical point of view, with an emphasis on advanced retrieval techniques.

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Section: Introductionmentioning

confidence: 99%

Inferior vena cava filter retrievals, standard and novel techniques

Kuyumcu¹,

Walker²

2016

Cardiovasc. Diagn. Ther.

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“…Unfractionated Heparin (UFH) is not recommened to prevent DVT in trauma patients [5]. However, in Japan, Low-MolecularWeight Heparin (LMWH) is not approved to administer to a trauma patient who has not undergone an operation in order to prevent DVT.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Adrenal Hemorrhage Secondary to Heparin Induced Thrombocytopenia in a Trauma Patient

Hamanaka¹

2014

Trauma Treat

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“…In the case of DVT, patients often present with pain and edema of the affected extremity [69][70][71]. Other symptoms include tenderness of the extremity, sometimes with a palpable mass, skin blanching, and excessive warmth or redness in the extremity [16,31,43,69]. In the case of PE, common presenting signs and symptoms include dyspnea, pleuritic pain, cough, hemoptysis, and palpitation [69,72].…”

Section: Presenting Signs and Symptomsmentioning

confidence: 99%

“…Studies have shown that other risk factors for VTE include age, sex, ethnicity, blood type, length of hospital stay, operative duration, and coagulation status [3,6,[8][9][10]14,[25][26][27][28][29][30][31][32][33][34][35][36][37][38]. Standard prophylactic measures for VTE include chemical anticoagulation, mechanical prophylaxis, and increased ambulation during the post-operative period [36,[39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54]. This paper seeks to review the relevant and current literature on VTE in brain tumor patients, with particular focus on the risk factors and presenting symptoms of VTE, treatment options for those with VTE, and a review of current prophylactic measures for VTE.…”

Section: Introductionmentioning

confidence: 99%

Venous Thromboembolism in Brain Tumor Patients: A Review of Literature

Coté¹,

Smith

2015

J Hematol Thrombo Dis

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Venous thromboembolism (VTE) is a relatively common and well-described condition, affecting approximately 1-2% of the general population. VTE can lead to significant morbidity and death via pulmonary embolism (PE). During the post-operative period, VTE occurs at higher rates due to natural thrombotic responses to injury and limited post-operative mobility. In general, rates of post-operative VTE are higher in patients undergoing operations for cranial and spinal lesions than for lesions of other types, a phenomenon that is not fully explained. Several studies have demonstrated that other risk factors for VTE include age, sex, ethnicity, hospital stay length, and coagulation state. Aggressive chemical and mechanical measures for VTE prophylaxis are indicated in the postoperative period to prevent the formation of VTE. Here we review the literature on VTE in brain tumor patients, with a focus on their etiology, diagnosis, treatment, and prophylaxis.

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A Comparison of Low-Dose Heparin with Low-Molecular-Weight Heparin as Prophylaxis against Venous Thromboembolism after Major Trauma

Abstract: Low-molecular-weight heparin was more effective than low-dose heparin in preventing venous thromboembolism after major trauma. Both interventions were safe.

Cited by 759 publications

References 40 publications

Inferior vena cava filter retrievals, standard and novel techniques

Inferior vena cava filter retrievals, standard and novel techniques

Bilateral Adrenal Hemorrhage Secondary to Heparin Induced Thrombocytopenia in a Trauma Patient

Venous Thromboembolism in Brain Tumor Patients: A Review of Literature

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