Increased activation of coagulation and formation of late deep venous thrombosis following discontinuation of thromboprophylaxis after hip replacement surgery

Dahl, Ola E.; Aspelin, Trude; Arnesen, Harald; Seljeflot, Ingebjørg; Kierulf, Peter; Ruyter, R.; Lyberg, Torstein

doi:10.1016/0049-3848(95)00180-y

Cited by 86 publications

(59 citation statements)

References 17 publications

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“…However, patients with an over-response to the surgical stimulus (i.e. patients at high risk of VTE) may benefit from adequate anticoagulation therapy during surgery and prolonged duration of thromboprophylaxis [3,4]. Therefore, the peri-operative management of patients undergoing THR would be greatly improved if a simple, noninvasive clinical test was available for clinicians to evaluate the intensity of coagulation activation after THR, which could help to identify patients at high risk of VTE or bleeding.…”

Section: Introductionmentioning

confidence: 99%

Differences in urinary prothrombin fragment 1 + 2 levels after total hip replacement in relation to venous thromboembolism and bleeding events

Borris

Breindahl²,

Lassen

et al. 2008

Journal of Thrombosis and Haemostasis

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To cite this article: Borris LC, Breindahl M, Lassen MR, Pap AF, Misselwitz F. Differences in urinary prothrombin fragment 1 + 2 levels after total hip replacement in relation to venous thromboembolism and bleeding events. J Thromb Haemost 2008; 6: 1671-9.Summary. Background: Prothrombin fragment 1 + 2 is excreted in urine (uF1 + 2) as a result of thrombin generation and, therefore, may be a useful marker of coagulation status. Objectives: To assess uF1 + 2 levels after total hip replacement (THR) in patients with venous thromboembolism (VTE) and bleeding events. Patients/methods: This study was conducted in parallel with a prospective, dose-finding study evaluating the efficacy and safety of different doses of rivaroxaban (Xarelto Ò , Bayer HealthCare AG, Wuppertal, Germany) for thromboprophylaxis, relative to enoxaparin. Deep vein thrombosis was diagnosed by mandatory venography performed 5-9 days after THR, or earlier if symptomatic. Symptomatic pulmonary embolism was diagnosed by objective testing. Bleeding complications were registered and stratified into major bleeding, clinically relevant, non-major bleeding, and minor bleeding, using predefined criteria. Results: Eighty-four patients had a VTE and 57 patients had a bleeding event (n = 722). Significantly higher median uF1 + 2 levels were observed in the VTE group on day 3 after THR (P = 0.03), compared with control. Median uF1 + 2 levels were lower in the bleeding group on day 3 after THR (P = 0.005) and on the day of venography (P = 0.36), compared with control. Comparisons between the VTE and bleeding groups showed significantly lower median uF1 + 2 levels in the bleeding group on day 3 after THR and on the day of venography (P < 0.0001 and P = 0.006, respectively). Conclusions: Measurement of uF1 + 2 could provide a simple clinical test to evaluate noninvasively the intensity of coagulation activation after THR. However, further studies are required to confirm these encouraging preliminary results.

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Section: Introductionmentioning

confidence: 99%

Differences in urinary prothrombin fragment 1 + 2 levels after total hip replacement in relation to venous thromboembolism and bleeding events

Borris

Breindahl²,

Lassen

et al. 2008

Journal of Thrombosis and Haemostasis

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“…Usually the thrombus lyses with complete recovery. Late pulmonary embolism however has been reported even 40 days after surgery [3][4][5]. At present no clear indication about the need for prolonged anticoagulation in small distal DVT has been provided.…”

Section: Introductionmentioning

confidence: 99%

Prophylaxis of Venous Thromboembolism in Knee Replacement Surgery

Rostagno¹,

Carulli²,

Cartei³

et al. 2016

Prog Orthop Sci

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Venous thromboembolism (VTE) is still a frequent and sometimes severe complication after knee replacement surgery. Both pharmacological and non-pharmacological measures have been widely used to decrease VTE risk. Non pharmacological treatment include measures directed to decrease the effects of blood stasis, intermittent pneumatic compression device (IPCD) and graduated compression stockings, and mechanical devices. Pharmacological prophylaxis of venous thromboembolism (VTE) is associated with a more significant decrease in the incidence of deep venous thrombosis (DVT) and related complications after knee arthroplasty however anticoagulation may increase the risk of postoperative bleeding and related complications, in particular the need for re-intervention. Aim of present review was to suggest practical approach to DVT prophylaxis in patients undergoing knee arthroplasty. Although parenteral drugs (low dose unfractionated heparin, low molecular weight heparin and fondaparinux) are the more frequently employed agents, limited compliance may be a concern. Recent studies suggest that direct oral anticoagulants, antithrombin and anti Xa agent, might be a useful alternative although safety may limited by an higher rate of local bleeding.

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“…Hypercoagulability seems to last for 6 weeks or more following hip arthroplasty particularly if prophylaxis is discontinued. This parallels reduced venous blood flow and an increased formation of late deep vein thrombosis [30,31].…”

Section: Hypercoagulabilitymentioning

confidence: 99%

Thromboembolism and thromboprophylaxis in high risk surgery: facts and assumptions - a topic for emotions?

2000

Eur J Anaesthesiol

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Major orthopaedic surgery is associated with serious coagulation related complications. Perioperative cardio‐respiratory and vascular dysfunction have regularly been reported in connection with hip replacement surgery and account for a mortality up to 0.5%[1–2]. Organ failure syndromes, myocardial insufficiency and infarction, brain stroke and clinical venous thromboembolism may occur from the time of the trauma and until many weeks after and account for additionally 3–4%[1–7].

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Increased activation of coagulation and formation of late deep venous thrombosis following discontinuation of thromboprophylaxis after hip replacement surgery

Cited by 86 publications

References 17 publications

Differences in urinary prothrombin fragment 1 + 2 levels after total hip replacement in relation to venous thromboembolism and bleeding events

Differences in urinary prothrombin fragment 1 + 2 levels after total hip replacement in relation to venous thromboembolism and bleeding events

Prophylaxis of Venous Thromboembolism in Knee Replacement Surgery

Thromboembolism and thromboprophylaxis in high risk surgery: facts and assumptions - a topic for emotions?

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