Randomized clinical trial of postoperative fondaparinux <i>versus</i> perioperative dalteparin for prevention of venous thromboembolism in high-risk abdominal surgery

Agnelli, Giancarlo; Bergqvist, David; Cohen, Alexander T.; Gallus, Alexander; Gent, Michael

doi:10.1002/bjs.5154

Cited by 325 publications

(190 citation statements)

References 24 publications

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“…1), supporting the adequacy of the prophylactic dose of 2.5 mg of fondaparinux and in accord with the substantial efficacy data already available with respect to a dose of 2.5 mg of fondaparinux in various clinical settings. [20][21][22][23] We chose a 45-day duration of treatment with the specific objective of avoiding the "catch-up" phenomenon observed with shorter (up to 30-day) courses of low-molecular-weight heparin. 6,17 This objective was met, since the efficacy of fondaparinux efficacy was maintained through day 77.…”

Section: By Day 47mentioning

confidence: 99%

Fondaparinux for the Treatment of Superficial-Vein Thrombosis in the Legs

et al. 2010

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Section: By Day 47mentioning

confidence: 99%

Fondaparinux for the Treatment of Superficial-Vein Thrombosis in the Legs

et al. 2010

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“…Guidelines have been established on the necessity, intensity and duration of postoperative antithrombotic prophylaxis. 1 While the optimal postoperative antithrombotic management has been well defined 2 for most types of abdominal surgery, the postoperative risk and antithrombotic prophylaxis after splenectomy have not been studied systematically, although the risk may be considerable in some groups of patients.…”

Section: Introductionmentioning

confidence: 99%

The postoperative splenic/portal vein thrombosis after splenectomy and its prevention - an unresolved issue

Krauth¹,

Lechner²,

Neugebauer³

et al. 2008

Haematologica

122

103

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Patients undergoing splenectomy have an increased risk of splenic/portal vein thrombosis. We used several databases to identify publications dealing with this risk and analyzed incidence, risk factors and outcome. The risk of splenic portal vein thrombosis has been addressed in prospective and retrospective randomized or non-randomized studies. All studies combined, the overall risk is 3.3%. Risk factors are big spleens (i.e. myeloproliferative disorders) and hereditary hemolytic anemias, whereas the risk is low in autoimmune thrombocytopenia and trauma. The incidence is approximately the same in laparascopic and open splenectomy. The median time from splenectomy to symptomatic splenic vein thrombosis is 8-12 days. Postoperative antithrombotic prophylaxis ranged from no prophylaxis to heparin for seven days or longer. Treatment of symptomatic splenic vein thrombosis with heparin and warfarin leads to complete resolution of thrombosis in 67%, to partial resolution in 13%, but persistent occlusion, portal hypertension or cavernoma occurred in 20%. The long-term outcome of treatment failures is unknown. Well-designed randomized studies on the prophylaxis of venous thromboembolism after splenectomy are urgently needed.Key words: portal vein thrombosis, risk factors, splenectomy, thromboembolism, treatment. Citation: Krauth M-T, Lechner K, Neugebauer EAM and Pabinger I. The postoperative splenic/portal vein thrombosis after splenectomy and its prevention -an unresolved issue.

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“…Th is could lead to a conclusion that patients on fondaparinux have less need for postoperative allotransfusion due to the less intraoperative and early postoperative bleeding. A recent study by Hosaka et al 10 confi rmed the opinions from previous studies that excessive bleeding can be expected in patients undergoing surgery and receiving fondaparinux 5,12,[15][16][17] . In their study, Hosaka et al assessed the safety of fondaparinux versus enoxaparin after TKA in Japanese patients and concluded that thigh swelling and subcutaneous hematomas were greater in the fondaparinux group.…”

Section: Discussionmentioning

confidence: 71%

Influence of Fondaparinux Versus Nadroparin Calcium Thromboprophylaxis on Clinical Parameters Following Total Knee Arthroplasty

Mihaljević¹

2016

acc

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SUMMARY -Fondaparinux has been shown to be as eff ective as low molecular weight heparin in orthopedic surgery, with no cases of heparin induced thrombocytopenia proven until today. Th e main goal of this prospective randomized controlled trial was to defi ne whether thromboprophylaxis in patients with primary osteoarthritis of the knee undergoing total knee arthroplasty (TKA) infl uences clinical parameters in the same manner in patients receiving fondaparinux as in those receiving nadroparin during the fi rst 7 postoperative days. Sixty patients with primary knee osteoarthritis underwent unilateral TKA performed by the same surgeon and were randomized into two groups of 30 patients receiving either fondaparinux or nadroparin thromboprophylaxis. Patients were compared according to the duration of operation, perioperative blood loss, laboratory results and clinical evaluation of the edema during the early postoperative period. No diff erences were found between the groups in the mean duration of surgery, perioperative blood loss, and most of laboratory results. Th e level of urea was signifi cantly lower in the nadroparin group on the fi rst and second postoperative day. No cases of heparin induced thrombocytopenia, deep vein thrombosis or pulmonary embolism were noted during the study. Study results showed both fondaparinux and nadroparin to have the same infl uence on clinical parameters during the fi rst 7 postoperative days in patients undergoing TKA.

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Randomized clinical trial of postoperative fondaparinux versus perioperative dalteparin for prevention of venous thromboembolism in high-risk abdominal surgery

Abstract: Postoperative fondaparinux was at least as effective as perioperative dalteparin in patients undergoing high-risk abdominal surgery.

Cited by 325 publications

References 24 publications

Fondaparinux for the Treatment of Superficial-Vein Thrombosis in the Legs

Fondaparinux for the Treatment of Superficial-Vein Thrombosis in the Legs

The postoperative splenic/portal vein thrombosis after splenectomy and its prevention - an unresolved issue

Influence of Fondaparinux Versus Nadroparin Calcium Thromboprophylaxis on Clinical Parameters Following Total Knee Arthroplasty

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