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Extended DVT prophylaxis

Mark A Snyder, Alexandra N Sympson, Christina M Scheuerman, Justin L Gregg, Lala R Hussain
BACKGROUND: Aspirin at 325 mg twice daily is now included as a nationally approved venous thromboembolism (VTE) prophylaxis protocol for low-risk total knee arthroplasty (TKA) patients. The purpose of this study is to examine whether there is a difference in deep vein thrombosis (DVT) occurrence after a limited tourniquet TKA using aspirin-based prophylaxis with or without extended use of mechanical compression device (MCD) therapy. METHODS: One hundred limited tourniquet TKA patients, whose DVT risk was managed with aspirin 325 mg twice daily for 3 weeks, were randomized to either using an MCD during hospitalization only or extended use at home up to 6 weeks postoperatively...
December 23, 2016: Journal of Arthroplasty
Francesco Dentali, Nicola Mumoli, Domenico Prisco, Andrea Fontanella, Matteo Nicola Dario Di Minno
Compelling evidence suggests that the risk of pulmonary embolism (PE) and deep-vein thrombosis (DVT) persists after hospital discharge in acutely-ill medical patients. However, no studies consistently supported the routine use of extended-duration thromboprophylaxis (ET) in this setting. We performed a meta-analysis to assess efficacy and safety of ET in acutely-ill medical patients. Efficacy outcome was defined by the prevention of symptomatic DVT, PE, venous thromboembolism (VTE) and VTE-related mortality...
February 28, 2017: Thrombosis and Haemostasis
Aaron Y L Liew, Siavash Piran, John W Eikelboom, James D Douketis
Extended-duration pharmacological thromboprophylaxis, for at least 28 days, is effective for the prevention of symptomatic venous thromboembolism (VTE) in high-risk surgical patients but is of uncertain benefit in hospitalized medical patients. We aimed to evaluate the efficacy and safety of extended-duration thromboprophylaxis in hospitalized medical patients. We conducted a systematic PubMed, Medline and EMBASE literature search until June 2016 and a meta-analysis of randomized controlled trials which compared extended-duration with short-duration thromboprophylaxis in hospitalized medical patients...
April 2017: Journal of Thrombosis and Thrombolysis
Haider Mahdi, Qataralnada Aljebori, David Lockart, Laura Moulton
STUDY OBJECTIVE: To determine the incidence of venous thromboembolism (VTE) after laparoscopic surgery for gynecologic cancer DESIGN: Retrospective analysis of the ACS-NSQIP database DESIGN CLASSIFICATION: Retrospective analysis of a national surgical database SETTING: Academic and community health care institutions across the United States PATIENTS: Women who underwent at least one major laparoscopic surgery for uterine, ovarian and cervical cancers INTERVENTION: Data was collected on surgical procedure, patient demographic variables type of malignancy and VTE and mortality outcomes within 30 days of surgery MEASUREMENTS: VTE was defined as deep venous thrombosis requiring therapy (DVT) and pulmonary embolism (PE) confirmed by imaging or autopsy within 30 days of surgery...
June 21, 2016: Journal of Minimally Invasive Gynecology
C I Piatek, S T Tagawa, D Wei-Tsai, D Hanna, I C Weitz, C O'Connell, L Rochanda, S Groshen, H A Liebman
INTRODUCTION: VTE is a major complication in cancer patients. Despite treatment with low molecular weight heparin (LMWH), 9% will have recurrent VTE within 6 months. Measurement of plasma biomarkers in cancer patients receiving LMWH may be predictive of recurrent VTE or overall survival (OS). AIM: We conducted a single arm phase 2 study to evaluate the efficacy and safety of once daily tinzaparin for the initial treatment and extended prophylaxis of VTE in cancer patients...
April 2016: Thrombosis Research
L Solari, M Krönig, G Ihorst, K Drognitz, J Heinz, C A Jilg, W Schultze-Seemann, M Engelhardt, Cornelius F Waller
BACKGROUND: We examined whether or not extended prophylaxis with low molecular weight heparin (LMWH) would significantly reduce thromboembolic event (TEE) rates in germ cell cancer patients undergoing cisplatin-based chemotherapy. PATIENTS AND METHODS: LMWH prophylaxis was given from the first day of chemotherapy until 21 days after completing the last chemotherapy cycle to 45 out of 93 (48.4%) patients (extended), and to 48 out of 93 (51.6%) patients during their hospitalization only (limited) between January 2008 and December 2013...
2016: Urologia Internationalis
Rachel Forster, Marlene Stewart
BACKGROUND: The optimal duration of thromboprophylaxis after total hip or knee replacement, or hip fracture repair remains controversial. It is common practice to administer prophylaxis using low-molecular-weight heparin (LMWH) or unfractionated heparin (UFH) until discharge from hospital, usually seven to 14 days after surgery. International guidelines recommend extending thromboprophylaxis for up to 35 days following major orthopaedic surgery but the recommendation is weak due to moderate quality evidence...
March 30, 2016: Cochrane Database of Systematic Reviews
John Agzarian, Waël C Hanna, Laura Schneider, Colin Schieman, Christian J Finley, Yury Peysakhovich, Terri Schnurr, Dennis Nguyen-Do, Lori-Ann Linkins, James Douketis, Mark Crowther, Marc De Perrot, Thomas K Waddell, Yaron Shargall
OBJECTIVES: To determine the prevalence of delayed postoperative venous thromboembolism (VTE) in patients undergoing oncologic lung resections, despite adherence to current in-hospital VTE prophylaxis guidelines. METHODS: Patients undergoing lung resection for malignancy in 2 tertiary-care centers were recruited between June 2013 and December 2014. All patients received guideline-based VTE prophylaxis until hospital discharge. Patients underwent computed tomography chest angiography with pulmonary embolism (PE) protocol and bilateral lower extremity venous Doppler ultrasonography at 30 ± 5 days after surgery to determine the incidence of postoperative VTE...
April 2016: Journal of Thoracic and Cardiovascular Surgery
Johannes Thaler, Ingrid Pabinger, Cihan Ay
Venous thromboembolism (VTE), a disease entity comprising deep vein thrombosis (DVT) and pulmonary embolism (PE), is a frequent and potentially life-threatening event. To date different agents are available for the effective treatment of acute VTE and the prevention of recurrence. For several years, the standard of care was the subcutaneous application of a low molecular weight heparin (LMWH) or fondaparinux, followed by a vitamin K antagonist (VKA). The so-called direct oral anticoagulants (DOAC) were introduced rather recently in clinical practice for the treatment of VTE...
2015: Frontiers in Cardiovascular Medicine
Tarik Sammour, Raaj Chandra, James W Moore
There is level one evidence to support combined mechanical and chemical thromboprophylaxis for 7-10 days after colorectal cancer surgery, but there remains a paucity of data to support extended prophylaxis after discharge. The aim of this clinical review is to summarise the currently available evidence for extended venous thromboprophylaxis after elective colorectal cancer surgery. Clinical review of the major clinical guidelines and published clinical data evaluating extended venous thromboprophylaxis after elective colorectal cancer surgery...
July 2016: Journal of Thrombosis and Thrombolysis
Anamaria Vera Jugrin, Anastasia Ustyugova, Michael Urbich, Mark Lamotte, Tom Sunderland
The relative efficacy and safety of dabigatran etexilate and warfarin have been evaluated in two head-to-head, phase III, treatment of acute venous thromboembolism (VTE) trials, and one extended prophylaxis trial, in patients with high risk of recurrent VTE. Dabigatran etexilate demonstrated similar efficacy to warfarin, and was associated with a reduced risk of major or clinically relevant bleeds. Based on results of these trials, and real-life disease prognosis following discontinuation of anticoagulation treatment, we evaluated the cost-utility of dabigatran etexilate compared with warfarin in six months anticoagulation, and in extended, up to 24 months anticoagulation, in patients with acute VTE, acute deep-vein thrombosis (DVT) or acute, symptomatic, pulmonary embolism (PE)...
October 2015: Thrombosis and Haemostasis
Aaron M Potretzke, Kelvin S Wong, Fangfang Shi, William Christensen, Tracy M Downs, E Jason Abel
CONTEXT: Venous thromboembolism (VTE) is a common cause of postoperative morbidity and mortality in cystectomy patients. AIMS: The aim of this study is to identify variables associated with risk of developing deep venous thrombosis (DVT) or pulmonary embolism (PE) within 90 days after radical cystectomy (RC). SETTING AND DESIGN: Retrospective chart review of patients undergoing RC from 2004 to 2011 at the University of Wisconsin. SUBJECTS AND METHODS: Clinical variables collected for all RC patients...
July 2015: Urology Annals
Hongxiu Luo, Sunil Tulpule, Mahmood Alam, Reema Patel, Shuvendu Sen, Abdalla Yousif
Hürthle cell carcinoma (HCC) is a variant of a follicular carcinoma with a tendency to higher frequency of metastases and a lower survival rate. However, intracavitary cardiac metastases from thyroid HCC are extremely rare. We describe the case of a 57-year-old female with thyroid HCC, 5 years after total thyroidectomy, who presented with dyspnea associated with hypoxia and hypotension. The computed tomography angiogram showed extensive pulmonary embolism and a 6-cm right atrial mass while the lower-extremity deep vein thrombosis studies were negative...
May 2015: Case Reports in Oncology
Serena Granziera, Alexander T Cohen
Primary prevention is the key to managing a significant proportion of the burden of venous thromboembolism (VTE), defined as deep venous thrombosis (DVT) or pulmonary embolism (PE). This is because VTE may lead to sudden death or are often misdiagnosed and therefore treatment is not feasible. Primary prevention usually commences in hospital as VTE following hospitalisation adds to the significant disease burden worldwide. Numerous medical, surgical and other risk factors have been recognised and studied as indications for prophylaxis...
June 2015: Thrombosis and Haemostasis
M Baba, M Al-Masri, M Salhab, M El-Ghanem
UNLABELLED: Effective Venous Thrombo-Embolism (VTE) prophylaxis is used in less than 50% of oncology patients despite its wide availability. Low molecular weight heparin (LMWH) as a daily injection is an essential tool for effective prophylaxis against deep vein thrombosis (DVT). Daily outpatient self-injection by the patients or their family members is common practice. The effectiveness of this measure depends on patient compliance. OBJECTIVE: The purpose of this study is to determine the degree of compliance and the factors that affect compliance to the extended out-patient use of prophylactic LMWH for 1 month after major abdominal/pelvic surgeries in cancer patients at King Hussein Cancer Center (KHCC)...
January 2015: Gulf Journal of Oncology
J Dixon, E Ahn, L Zhou, R Lim, D Simpson, E G Merriman
BACKGROUND/AIM: Symptomatic venous thromboembolism (VTE) complicates approximately 4% of major orthopaedic surgical procedures performed without thromboprophylaxis. Randomised clinical trials demonstrate primary thromboprophylaxis reduces VTE rates to <1%, with low rates of clinically important bleeding, using low molecular weight heparin (LMWH), oral FXa inhibitors or thrombin inhibitors. We reviewed the rates of VTE in patients undergoing major hip/knee joint surgery at Waitemata District Health Board (WDHB)...
April 2015: Internal Medicine Journal
Chia-Chi Chu, Hirofumi Haga
BACKGROUND: Trauma patients have the highest risk of developing venous thromboembolism (VTE) among hospitalised patients, with a reported 13-fold greater risk of developing VTE over non-trauma patients. This study examines the incidence of VTE and associated complications in trauma patients with lower limb fractures or injuries. METHODS: We retrospectively analysed 6,227 trauma patients and classified them according to injury severity score (ISS). The minor trauma group (ISS ≤15) contained 5,637 patients and the major trauma group (ISS >15) contained 590 patients...
March 2015: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Gary H Lyman, Kari Bohlke, Alok A Khorana, Nicole M Kuderer, Agnes Y Lee, Juan Ignacio Arcelus, Edward P Balaban, Jeffrey M Clarke, Christopher R Flowers, Charles W Francis, Leigh E Gates, Ajay K Kakkar, Nigel S Key, Mark N Levine, Howard A Liebman, Margaret A Tempero, Sandra L Wong, Mark R Somerfield, Anna Falanga
PURPOSE: To provide current recommendations about the prophylaxis and treatment of venous thromboembolism (VTE) in patients with cancer. METHODS: PubMed and the Cochrane Library were searched for randomized controlled trials, systematic reviews, meta-analyses, and clinical practice guidelines from November 2012 through July 2014. An update committee reviewed the identified abstracts. RESULTS: Of the 53 publications identified and reviewed, none prompted a change in the 2013 recommendations...
February 20, 2015: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Marcin Warot, Tomasz Synowiec, Agnieszka Wencel-Warot, Przemysław Daroszewski, Iwona Bojar, Maciej Micker, Paweł Chęciński
INTRODUCTION: Chronic venous disease is a group of symptoms caused by functional and structural defects of the venous vessels. One of the most common aspects of this disease is the occurrence of varicose veins. There are many ways of prevention and treatment of varicose veins, but in Poland the leading one is still surgery. As in every medical procedure there is the possibility of some complications. One of them is deep vein thrombosis (DVT). The diagnosis of DVT can be difficult, especially when access to a specialist is limited, such as in case of rural patients...
2014: Annals of Agricultural and Environmental Medicine: AAEM
Andrew J Sun, Hooman Djaladat, Anne Schuckman, Gus Miranda, Jie Cai, Siamak Daneshmand
PURPOSE: We determined the rate, timing and predictors of venous thromboembolism after open radical cystectomy for urothelial bladder cancer. We also compared the use of warfarin (1971 to 2008) and unfractionated heparin (2008 to 2012) as prophylaxis. MATERIALS AND METHODS: We retrospectively reviewed the records of 2,316 patients who underwent open radical cystectomy and extended pelvic lymph node dissection for urothelial bladder cancer with intent to cure at our institution between 1971 and 2012...
February 2015: Journal of Urology
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