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Giulio Illuminati, Francesco G Calio', Giulia Pizzardi, Chiara Amatucci, Federica Masci, Piergaspare Palumbo
INTRODUCTION: Intra and perioperative anticoagulation in patients with heparin induced thrombocytopenia (HIT), candidates for peripheral vascular surgery remains a challenge, as the best alternative to heparin has not yet been established. We evaluated the off-label use of fondaparinux in four patients with HIT, undergoing peripheral vascular surgery procedures. PRESENTATION OF CASES: Four patients of whom 3 men of a mean age of 66 years, with proven heparin induced thrombocytopenia (HIT) underwent two axillo-femoral bypasses, one femoro-popliteal bypass and one resection of a splenic artery aneurysm under fondaparinux...
October 8, 2016: International Journal of Surgery Case Reports
Jamshed J Dalal, Anil Dhall, Abhay Bhave
Oral vitamin K antagonists (VKA) such as warfarin have been the mainstay of therapy for stroke prevention in patients with non valvular atrial fibrillation (NVAF) while low-molecular-weight heparin, fondaparinux and adjusted-dose warfarin or aspirin have been routinely used for thromboembolism (VTE) prophylaxis in patients undergoing total hip or knee replacement. However, VKAs are associated with considerable limitations, including increased risk of bleeding and narrow therapeutic window. Novel oral anticoagulants (NOACs, now referred as Non Vit K dependent oral anticoagulants), including the direct thrombin inhibitor dabigatran and direct Factor Xa inhibitors such as rivaroxaban and apixaban are now approved alternatives to warfarin for prophylaxis of stroke and systemic embolic events (SEE) in patients with NVAF and treatment and prophylaxis of VTE...
April 2016: Journal of the Association of Physicians of India
Pierre-Antoine Moulin, Anne Dutour, Patricia Ancel, Pierre-Emmanuel Morange, Thierry Bege, Olivier Ziegler, Stéphane Berdah, Corinne Frère, Bénédicte Gaborit
BACKGROUND: Venous thromboembolism (VTE) is a leading cause of death in obese patients undergoing bariatric surgery (BS), but there is neither consensus nor high-level guidelines yet on VTE prophylaxis in this specific population. OBJECTIVE: We aimed to evaluate patterns of BS perioperative thromboprophylaxis practices. SETTING: French obesity specialized care centers (CSO), which are tertiary care referral hospitals for the most severe cases of obesity METHODS: A detailed questionnaire survey (11 opened, 15 closed questions) investigating their prophylactic schemes of anticoagulation (molecule, dose, weight-adjustment, duration, associated measures, follow-up) was sent to the 37 CSO...
September 1, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Lukas Goertz, Stefan Werner Schneider, Anna Desch, Frank Thomas Mayer, Julian Koett, Kai Nowak, Ioannis Karampinis, Michael K Bohlmann, Viktor Umansky, Alexander Thomas Bauer
Von Willebrand factor (VWF) serves as a nidus for platelet aggregation and thrombosis. We hypothesize that VWF fibers contribute to the development of venous thromboembolism (VTE) and to metastasis formation. Here, we show that vascular and lymphatic endothelial cells (ECs) express VWF in vitro and release VWF fibers after activation by tumor cell supernatants. In contrast, an ex vivo analysis of primary mouse tumors revealed the presence of VWF fibers in the blood microvasculature but not in lymphatic vessels...
September 2, 2016: Oncotarget
Hikmat Abdel-Razeq, Asem Mansour
No abstract text is available yet for this article.
2016: Drug Design, Development and Therapy
M Khoury, A Pitsis, H Poumpouridou-Kioura, G Soufla, C Kanthou, N Matoula, A Angelidis, E Melissari
INTRODUCTION: Systemic anticoagulation is necessary during cardiac surgery. To date, the only well established anticoagulation protocol involves the use of heparin. However, heparin can cause heparin-induced thrombocytopenia (HIT) a potentially life threatening immune-mediated thromboembolic syndrome. Until now, devastating consequences of HIT syndrome in patients undergoing heart surgery have been described, but only postoperatively. Here we report the development of HIT syndrome during cardiac revascularization by intra-operative heparin administration in two patients previously exposed to LMWH...
October 2016: Thrombosis Research
Albrecht Encke, Sylvia Haas, Ina Kopp
BACKGROUND: Venous thromboembolism (VTE) is the third most common cardiovascular condition, after myocardial infarction and stroke. Prophylactic measures in accordance with current guidelines can significantly reduce the risk of VTE and the associated morbidity and mortality. Until now, the German interdisciplinary, evidence- and consensus-based (S3) clinical practice guideline on VTE prophylaxis was based on a complete review of all pertinent literature available in MEDLINE up to January 2008...
August 8, 2016: Deutsches Ärzteblatt International
Alexandre de Matos Soeiro, Pedro Gabriel Melo de Barros E Silva, Eduardo Alberto de Castro Roque, Aline Siqueira Bossa, Maria Cristina César, Sheila Aparecida Simões, Mariana Yumi Okada, Tatiana de Carvalho Andreucci Torres Leal, Fátima Cristina Monteiro Pedroti, Múcio Tavares de Oliveira
Background: Recent studies have shown fondaparinux's superiority over enoxaparin in patients with non-ST elevation acute coronary syndrome (ACS), especially in relation to bleeding reduction. The description of this finding in a Brazilian registry has not yet been documented. Objective: To compare fondaparinux versus enoxaparin in in-hospital prognosis of non-ST elevation ACS. Methods: Multicenter retrospective observational study. A total of 2,282 patients were included (335 in the fondaparinux group, and 1,947 in the enoxaparin group) between May 2010 and May 2015...
September 2016: Arquivos Brasileiros de Cardiologia
Masahiro Izumi, Tatsuya Sakai, Atsunori Shirakawa, Hideko Kozuru, Yuka Jiuchi, Yasumori Izumi, Tomohiko Asahara, Kenji Kumagai, Masaaki Mawatari, Makoto Osaki, Satoru Motokawa, Kiyoshi Migita
BACKGROUND: Heparin-induced thrombocytopenia is caused by antibodies (Abs) specific to platelet factor 4 (PF4)/heparin complexes. In this study, we evaluated the rates of seroconversion of anti-PF4/heparin Ab between patients with rheumatoid arthritis (RA) and with osteoarthritis (OA) who underwent total knee arthroplasty. METHODS: The subjects of this randomized controlled trial were 124 patients who underwent total knee arthroplasty (TKA) and received edoxaban with or without a foot pump as thromboprophylaxis...
2016: Arthritis Research & Therapy
Kenichi Hata, Takahiro Kimura, Shunsuke Tsuzuki, Gen Ishii, Masahito Kido, Toshihiro Yamamoto, Hiroshi Sasaki, Jun Miki, Hiroki Yamada, Akira Furuta, Kenta Miki, Shin Egawa
OBJECTIVES: To prospectively evaluate the safety of postoperative fondaparinux in comparison with low molecular weight heparin in patients undergoing uro-oncological surgery. METHODS: The present study was a prospective, single-blind, non-inferiority randomized trial. A total of 359 patients undergoing surgery for urological malignancy were enrolled from January 2011 to December 2012. A total of 298 of these patients (fondaparinux group, 152; low molecular weight heparin group, 146) were evaluable for the intention-to-treat-analysis...
August 21, 2016: International Journal of Urology: Official Journal of the Japanese Urological Association
Gary W Jean, Katherine Kelly, Jennie Mathew, Eneko Larumbe, Randall Hughes
PURPOSE: The purpose of this study is to compare the rates of recurrent VTE among cancer patients treated with parenteral agents to the oral anticoagulants. METHODS: This single-center study was a retrospective chart review of cancer patients with recurrent VTE between January 1, 2009 and December 31, 2014. The primary outcome of the study is the rate of recurrent VTE in patients who received a parenteral anticoagulant (enoxaparin, dalteparin, fondaparinux) versus those who received oral anticoagulants (warfarin and rivaroxaban)...
August 20, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Daniela Mastroiacovo, Girolamo Sala, Francesco Dentali
INTRODUCTION: Venous thromboembolism (VTE) is a common and potentially fatal disease. Fondaparinux is a synthetic agent able to act on single factors involved in the coagulation network, which could be administered at fixed doses and with a more predictable response. AREAS COVERED: This review will focus on the efficacy and safety of fondaparinux in the treatment of major VTE (deep vein thrombosis and pulmonary embolism) and in the treatment of superficial vein thrombosis (SVT)...
September 2016: Expert Opinion on Drug Safety
Charles J Glueck, Kevin Lee, Marloe Prince, Vybhav Jetty, Parth Shah, Ping Wang
BACKGROUND: When exogenous testosterone or treatments to elevate testosterone (human chorionic gonadotropin [HCG] or Clomid) are prescribed for men who have antecedent thrombophilia, deep venous thrombosis and pulmonary embolism often occur and may recur despite adequate anticoagulation if testosterone therapy is continued. CASE PRESENTATION: A 55-year-old white male was referred to us because of 4 thrombotic events, 3 despite adequate anticoagulation over a 5-year period...
July 2016: Journal of Investigative Medicine High Impact Case Reports
Hidetoshi Uchiyama, Yoshinori Inoue, Isao Uchimura, Tomomasa Nakamura, Toshifumi Kudo, Takeshi Muneta, Tatsuyuki Kawano
BACKGROUND: Venous thromboembolism (VTE) including deep vein thrombosis (DVT) and pulmonary embolism (PE) frequently occurs in patients undergoing total knee arthroplasty (TKA). This study aimed to evaluate the efficacy of dielectric blood coagulometry (DBCM) as a new technique for predicting postoperative VTE. METHODS: Thirty patients undergoing TKA were enrolled. DVT was diagnosed by ultrasonography preoperatively and on the fourth or fifth postoperative day. Enhanced computed tomography (CT) was performed to detect PE on the fourth postoperative day...
August 11, 2016: Annals of Vascular Surgery
Megan Y Harada, David M Hoang, Andrea A Zaw, Jason S Murry, Oksana Volod, Beatrice J Sun, Miriam Nuño, Russell Mason, Daniel R Margulies, Eric J Ley
OBJECTIVE: Recent studies reveal a high occurrence of overdiagnosis of heparin-induced thrombocytopenia in surgical patients with critical illness. The optimal criteria for diagnosis of heparin-induced thrombocytopenia remain unclear, contributing to unnecessary treatment. We reviewed patients who were admitted to surgical ICUs and were suspected of heparin-induced thrombocytopenia to identify how often patients were correctly treated. DESIGN: In this clinical prospective study, data were collected including age, sex, antiplatelet factor 4/heparin enzyme-linked immunosorbent assay, serotonin release assay, and Warkentin 4Ts scores...
August 4, 2016: Critical Care Medicine
Kazuhiro Shimizu, Takeshi Sasaki, Takanobu Tomaru, Hirofumi Noike
BACKGROUND: Factor Xa inhibitor is a key drug in the coagulation cascade. Parenteral anticoagulation using low molecular weight heparin or fondaparinux is the recommended form of treatment for most patients presenting with venous thrombosis. Following the acute phase, edoxaban is recommended. We present a case of extensive deep vein thrombosis treated using fondaparinux and edoxaban. CASE PRESENTATION: A 63-year-old man with redness, pain, and swelling of the left leg lasting for more than 1 month was referred to our hospital...
2016: Thrombosis Journal
Erin A Vogel, Sarah J Billups, Sheryl J Herner, Thomas Delate
OBJECTIVE: The purpose of this study was to compare the effectiveness of an outpatient renal dose adjustment alert via a computerized provider order entry (CPOE) clinical decision support system (CDSS) versus a CDSS with alerts made to dispensing pharmacists. METHODS: This was a retrospective analysis of patients with renal impairment and 30 medications that are contraindicated or require dose-adjustment in such patients. The primary outcome was the rate of renal dosing errors for study medications that were dispensed between August and December 2013, when a pharmacist-based CDSS was in place, versus August through December 2014, when a prescriber-based CDSS was in place...
2016: Applied Clinical Informatics
Bartlomiej Kalaska, Kamil Kaminski, Joanna Miklosz, Shin-Ichi Yusa, Emilia Sokolowska, Agnieszka Blazejczyk, Joanna Wietrzyk, Irena Kasacka, Krzysztof Szczubialka, Dariusz Pawlak, Maria Nowakowska, Andrzej Mogielnicki
The parenteral anticoagulants may cause uncontrolled and life-threatening bleeding. Protamine, the only registered heparin antidote, is partially effective against low-molecular weight heparins, completely ineffective against fondaparinux and may cause unacceptable toxicity. Therefore, we aimed to develop a synthetic compound for safe and efficient neutralization of all parenteral anticoagulants. We synthesized pegylated PMAPTAC block copolymers, and then, we selected a lead heparin-binding copolymer (HBC)...
July 5, 2016: Translational Research: the Journal of Laboratory and Clinical Medicine
Wen-Jun Dong, Hui-Juan Qian, Yan Qian, Ling Zhou, San-Lian Hu
The aim of the study was to compare the efficacy and safety profiles of fondaparinux and enoxaparin in preventing the venous thromboembolism (VTE) after total hip replacement. A systematic literature search in the PubMed, EMBASE and Cochrane library databases was performed to identify relevant articles published in English since inception up to November 16, 2014. The efficacy outcomes were all VTE, total deep vein thrombosis (DVT) and symptomatic VTE, while the safety outcome was major bleeding. Four eligible studies were included in the meta-analysis...
August 2016: Experimental and Therapeutic Medicine
Damien Balestrino, Mercédès Quintana, Nicolas Charbonnel, Christiane Forestier, Claire Lartigue, Bertrand Souweine
BACKGROUND AND OBJECTIVES: Interdialytic lock solutions should maintain catheter patency and prevent catheter infections. We aimed to determine in which conditions injectable anticoagulant agents (IAAs) combined with ethanol are compatible and to assess the antibiofilm activity of the selected combination and its effects on dialysis catheters (DC). METHODS: The solubility and compatibility of unfractionated heparin (UFH), low molecular weight heparins (LMWHs), heparinoids and fondaparinux (50 to 2,500 U/mL) in 30 to 70% ethanol were determined by visual observation...
2016: PloS One
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