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DOI: 10.1055/s-0031-1273089
Preventing Postsurgical Venous Thromboembolism: Pharmacological Approaches
Publikationsverlauf
Publikationsdatum:
31. März 2011 (online)
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ABSTRACT
The use of antithrombotic drugs for the prevention of venous thromboembolism (VTE) in patients undergoing surgery is presently based on solid principles and high-level scientific evidence. This article reviews current strategies of pharmacological thromboprophylaxis. The level of VTE risk following surgery depends on a variety of factors that the surgeon should take into account, including the type of surgery and the presence of additional risk factors, such as elderly age and cancer. In patients undergoing minor general surgery, early mobilization is sufficient as prophylaxis, whereas in those undergoing major general surgery, thromboprophylaxis with low molecular weight heparin (LMWH), low-dose unfractionated heparin, or the pentasaccharide fondaparinux is recommended. Patients undergoing major orthopedic surgery have a particularly high risk of VTE, and routine thromboprophylaxis with LMWH, fondaparinux, or a vitamin K antagonist (international normalized ratio target: 2.0 to 3.0) is the standard of care in this group of patients. Recently, two new oral anticoagulants, rivaroxaban (a factor Xa inhibitor) and dabigatran etexilate (a direct thrombin inhibitor) have been licensed to be used for thromboprophylaxis after orthopedic surgery in Europe. Mechanical methods of thromboprophylaxis (compression stockings, intermittent pneumatic compression, vena cava filters), not discussed in detail in this review, should always be considered in patients at high thrombotic risk, in association with the pharmacolocical strategies, or in cases of contraindications to antocoagulants, as in patients or procedures at high risk of bleeding.
KEYWORDS
Antithrombotic drugs - prevention - venous thromboembolism - surgery - heparin - fondaparinux - rivaroxaban - dabigatran.
REFERENCES
- 1 Geerts W H, Bergqvist D, Pineo G F American College of Chest Physicians et al. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008; 133 (6, Suppl) 381S-453S
- 2 Naess I A, Christiansen S C, Romundstad P, Cannegieter S C, Rosendaal F R, Hammerstrøm J. Incidence and mortality of venous thrombosis: a population-based study. J Thromb Haemost. 2007; 5 (4) 692-699
- 3 Anderson Jr F A, Wheeler H B, Goldberg R J, Hosmer D W, Forcier A. The prevalence of risk factors for venous thromboembolism among hospital patients. Arch Intern Med. 1992; 152 (8) 1660-1664
- 4 Rosendaal F R. Risk factors for venous thrombotic disease. Thromb Haemost. 1999; 82 (2) 610-619
- 5 Anderson Jr F A, Spencer F A. Risk factors for venous thromboembolism. Circulation. 2003; 107 (23, Suppl 1) I9-I16
- 6 Samama M M, Dahl O E, Quinlan D J, Mismetti P, Rosencher N. Quantification of risk factors for venous thromboembolism: a preliminary study for the development of a risk assessment tool. Haematologica. 2003; 88 (12) 1410-1421
- 7 Kucher N, Tapson V F, Goldhaber S Z. DVT FREE Steering Committee . Risk factors associated with symptomatic pulmonary embolism in a large cohort of deep vein thrombosis patients. Thromb Haemost. 2005; 93 (3) 494-498
- 8 Kearon C. Natural history of venous thromboembolism. Circulation. 2003; 107 (23, Suppl 1) I22-I30
- 9 Sullivan S D, Kahn S R, Davidson B L, Borris L, Bossuyt P, Raskob G. Measuring the outcomes and pharmacoeconomic consequences of venous thromboembolism prophylaxis in major orthopaedic surgery. Pharmacoeconomics. 2003; 21 (7) 477-496
- 10 Caprini J A, Botteman M F, Stephens J M et al.. Economic burden of long-term complications of deep vein thrombosis after total hip replacement surgery in the United States. Value Health. 2003; 6 (1) 59-74
- 11 Avorn J, Winkelmayer W C. Comparing the costs, risks, and benefits of competing strategies for the primary prevention of venous thromboembolism. Circulation. 2004; 110 (24, Suppl 1) IV25-IV32
- 12 Nurmohamed M T, Rosendaal F R, Büller H R et al.. Low-molecular-weight heparin versus standard heparin in general and orthopaedic surgery: a meta-analysis. Lancet. 1992; 340 (8812) 152-156
- 13 Kakkar V V, Cohen A T, Edmonson R A The Thromboprophylaxis Collaborative Group et al. Low molecular weight versus standard heparin for prevention of venous thromboembolism after major abdominal surgery. Lancet. 1993; 341 (8840) 259-265
- 14 Koch A, Ziegler S, Breitschwerdt H, Victor N. Low molecular weight heparin and unfractionated heparin in thrombosis prophylaxis: meta-analysis based on original patient data. Thromb Res. 2001; 102 (4) 295-309
- 15 Haas S, Wolf H, Kakkar A K, Fareed J, Encke A. Prevention of fatal pulmonary embolism and mortality in surgical patients: a randomized double-blind comparison of LMWH with unfractionated heparin. Thromb Haemost. 2005; 94 (4) 814-819
- 16 Baglin T. Defining the population in need of thromboprophylaxis—making hospitals safer. Br J Haematol. 2010; 149 (6) 805-812
- 17 Lijfering W M, Rosendaal F R, Cannegieter S C. Risk factors for venous thrombosis—current understanding from an epidemiological point of view. Br J Haematol. 2010; 149 (6) 824-833
- 18 Hirsh J, Bauer K A, Donati M B, Gould M, Samama M M, Weitz J I. American College of Chest Physicians . Parenteral anticoagulants: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008; 133 (6, Suppl) 141S-159S
- 19 Ansell J, Hirsh J, Hylek E, Jacobson A, Crowther M, Palareti G. American College of Chest Physicians . Pharmacology and management of the vitamin K antagonists: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008; 133 (6, Suppl) 160S-198S
- 20 Patrono C, Baigent C, Hirsh J, Roth G. American College of Chest Physicians . Antiplatelet drugs: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008; 133 (6, Suppl) 199S-233S
- 21 Antiplatelet Trialists' Collaboration . Collaborative overview of randomised trials of antiplatelet therapy—III: Reduction in venous thrombosis and pulmonary embolism by antiplatelet prophylaxis among surgical and medical patients. Antiplatelet Trialists' Collaboration. BMJ. 1994; 308 (6923) 235-246
- 22 Lotke P A, Palevsky H, Keenan A M et al.. Aspirin and warfarin for thromboembolic disease after total joint arthroplasty. Clin Orthop Relat Res. 1996; 324 (324) 251-258
- 23 Pulmonary Embolism Prevention (PEP) Trial Collaborative Group . Prevention of pulmonary embolism and deep vein thrombosis with low dose aspirin: Pulmonary Embolism Prevention (PEP) trial. Lancet. 2000; 355 (9212) 1295-1302
- 24 Hovens M M, Snoep J D, Tamsma J T, Huisman M V. Aspirin in the prevention and treatment of venous thromboembolism. J Thromb Haemost. 2006; 4 (7) 1470-1475
- 25 McKenna R, Galante J, Bachmann F, Wallace D L, Kaushal P S, Meredith P. Prevention of venous thromboembolism after total knee replacement by high-dose aspirin or intermittent calf and thigh compression. BMJ. 1980; 280 (6213) 514-517
- 26 Powers P J, Gent M, Jay R M et al.. A randomized trial of less intense postoperative warfarin or aspirin therapy in the prevention of venous thromboembolism after surgery for fractured hip. Arch Intern Med. 1989; 149 (4) 771-774
- 27 Westrich G H, Sculco T P. Prophylaxis against deep venous thrombosis after total knee arthroplasty. Pneumatic plantar compression and aspirin compared with aspirin alone. J Bone Joint Surg Am. 1996; 78 (6) 826-834
- 28 Laux V, Perzborn E, Heitmeier S et al.. Direct inhibitors of coagulation proteins—the end of the heparin and low-molecular-weight heparin era for anticoagulant therapy?. Thromb Haemost. 2009; 102 (5) 892-899
- 29 Nishio H, Ieko M, Nakabayashi T. New therapeutic option for thromboembolism—dabigatran etexilate. Expert Opin Pharmacother. 2008; 9 (14) 2509-2517
- 30 Perzborn E, Strassburger J, Wilmen A et al.. In vitro and in vivo studies of the novel antithrombotic agent BAY 59-7939—an oral, direct factor Xa inhibitor. J Thromb Haemost. 2005; 3 (3) 514-521
- 31 Gulseth M P, Michaud J, Nutescu E A. Rivaroxaban: an oral direct inhibitor of factor Xa. Am J Health Syst Pharm. 2008; 65 (16) 1520-1529
- 32 Piccini J P, Patel M R, Mahaffey K W, Fox K A, Califf R M. Rivaroxaban, an oral direct factor Xa inhibitor. Expert Opin Investig Drugs. 2008; 17 (6) 925-937
- 33 Weinz C, Schwarz T, Kubitza D, Mueck W, Lang D. Metabolism and excretion of rivaroxaban, an oral, direct factor Xa inhibitor, in rats, dogs, and humans. Drug Metab Dispos. 2009; 37 (5) 1056-1064
- 34 Kakkar A K, Brenner B, Dahl O E RECORD2 Investigators et al. Extended duration rivaroxaban versus short-term enoxaparin for the prevention of venous thromboembolism after total hip arthroplasty: a double-blind, randomised controlled trial. Lancet. 2008; 372 (9632) 31-39
- 35 Eriksson B I, Borris L C, Friedman R J RECORD1 Study Group et al. Rivaroxaban versus enoxaparin for thromboprophylaxis after hip arthroplasty. N Engl J Med. 2008; 358 (26) 2765-2775
- 36 Lassen M R, Ageno W, Borris L C RECORD3 Investigators et al. Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty. N Engl J Med. 2008; 358 (26) 2776-2786
- 37 Turpie A GG, Lassen M R, Davidson B L RECORD4 Investigators et al. Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty (RECORD4): a randomised trial. Lancet. 2009; 373 (9676) 1673-1680
- 38 Mismetti P, Laporte S, Darmon J Y, Buchmüller A, Decousus H. Meta-analysis of low molecular weight heparin in the prevention of venous thromboembolism in general surgery. Br J Surg. 2001; 88 (7) 913-930
- 39 Koch A, Bouges S, Ziegler S, Dinkel H, Daures J P, Victor N. Low molecular weight heparin and unfractionated heparin in thrombosis prophylaxis after major surgical intervention: update of previous meta-analyses. Br J Surg. 1997; 84 (6) 750-759
- 40 Agnelli G, Bergqvist D, Cohen A T, Gallus A S, Gent M. PEGASUS investigators . Randomized clinical trial of postoperative fondaparinux versus perioperative dalteparin for prevention of venous thromboembolism in high-risk abdominal surgery. Br J Surg. 2005; 92 (10) 1212-1220
- 41 Turpie A G, Bauer K A, Caprini J A, Comp P C, Gent M, Muntz J E. Apollo Investigators . Fondaparinux combined with intermittent pneumatic compression vs. intermittent pneumatic compression alone for prevention of venous thromboembolism after abdominal surgery: a randomized, double-blind comparison. J Thromb Haemost. 2007; 5 (9) 1854-1861
- 42 Bergqvist D, Agnelli G, Cohen A T ENOXACAN II Investigators et al. Duration of prophylaxis against venous thromboembolism with enoxaparin after surgery for cancer. N Engl J Med. 2002; 346 (13) 975-980
- 43 Rasmussen M S, Jorgensen L N, Wille-Jørgensen P FAME Investigators et al. Prolonged prophylaxis with dalteparin to prevent late thromboembolic complications in patients undergoing major abdominal surgery: a multicenter randomized open-label study. J Thromb Haemost. 2006; 4 (11) 2384-2390
- 44 Dabrowiecki S, Rosc D, Jurkowski P. The influence of laparoscopic cholecystectomy on perioperative blood clotting and fibrinolysis. Blood Coagul Fibrinolysis. 1997; 8 (1) 1-5
- 45 Martinez-Ramos C, Lopez-Pastor A, Nùñez-Peña J R et al.. Changes in hemostasis after laparoscopic cholecystectomy. Surg Endosc. 1999; 13 (5) 476-479
- 46 Prisco D, De Gaudio A R, Carla R et al.. Videolaparoscopic cholecystectomy induces a hemostasis activation of lower grade than does open surgery. Surg Endosc. 2000; 14 (2) 170-174
- 47 Nguyen N T, Owings J T, Gosselin R et al.. Systemic coagulation and fibrinolysis after laparoscopic and open gastric bypass. Arch Surg. 2001; 136 (8) 909-916
- 48 Tincani E, Piccoli M, Turrini F, Crowther M A, Melotti G, Bondi M. Video laparoscopic surgery: is out-of-hospital thromboprophylaxis necessary?. J Thromb Haemost. 2005; 3 (2) 216-220
- 49 Bounameaux H, Didier D, Polat O, Desmarais S, de Moerloose P, Huber O. Antithrombotic prophylaxis in patients undergoing laparoscopic cholecystectomy. Thromb Res. 1997; 86 (3) 271-273
- 50 Baca I, Schneider B, Köhler T, Misselwitz F, Zehle A, Mühe F. Prevention of thromboembolism in minimal invasive interventions and brief inpatient treatment. Results of a multicenter, prospective, randomized, controlled study with a low molecular weight heparin. [in German] Chirurg. 1997; 68 (12) 1275-1280
- 51 Prystowsky J B, Morasch M D, Eskandari M K, Hungness E S, Nagle A P. Prospective analysis of the incidence of deep venous thrombosis in bariatric surgery patients. Surgery. 2005; 138 (4) 759-763 discussion 763-765
- 52 McCarty T M, Arnold D T, Lamont J P, Fisher T L, Kuhn J A. Optimizing outcomes in bariatric surgery: outpatient laparoscopic gastric bypass. Ann Surg. 2005; 242 (4) 494-498 discussion 498-501
- 53 Mason E E, Tang S, Renquist K E National Bariatric Surgery Registry (NBSR) Contributors et al. A decade of change in obesity surgery. Obes Surg. 1997; 7 (3) 189-197
- 54 Poulose B K, Griffin M R, Zhu Y et al.. National analysis of adverse patient safety for events in bariatric surgery. Am Surg. 2005; 71 (5) 406-413
- 55 Kalfarentzos F, Stavropoulou F, Yarmenitis S et al.. Prophylaxis of venous thromboembolism using two different doses of low-molecular-weight heparin (nadroparin) in bariatric surgery: a prospective randomized trial. Obes Surg. 2001; 11 (6) 670-676
- 56 Scholten D J, Hoedema R M, Scholten S E. A comparison of two different prophylactic dose regimens of low molecular weight heparin in bariatric surgery. Obes Surg. 2002; 12 (1) 19-24
- 57 Frederiksen S G, Hedenbro J L, Norgren L. Enoxaparin effect depends on body-weight and current doses may be inadequate in obese patients. Br J Surg. 2003; 90 (5) 547-548
- 58 Shepherd M F, Rosborough T K, Schwartz M L. Heparin thromboprophylaxis in gastric bypass surgery. Obes Surg. 2003; 13 (2) 249-253
- 59 Beksaç B, González Della Valle A, Salvati E A. Thromboembolic disease after total hip arthroplasty: who is at risk?. Clin Orthop Relat Res. 2006; 453 211-224
- 60 Mesko J W, Brand R A, Iorio R et al.. Venous thromboembolic disease management patterns in total hip arthroplasty and total knee arthroplasty patients: a survey of the AAHKS membership. J Arthroplasty. 2001; 16 (6) 679-688
- 61 Hull R D, Pineo G F, Francis C The North American Fragmin Trial Investigators et al. Low-molecular-weight heparin prophylaxis using dalteparin in close proximity to surgery vs warfarin in hip arthroplasty patients: a double-blind, randomized comparison. Arch Intern Med. 2000; 160 (14) 2199-2207
- 62 Mismetti P, Laporte S, Zufferey P, Epinat M, Decousus H, Cucherat M. Prevention of venous thromboembolism in orthopedic surgery with vitamin K antagonists: a meta-analysis. J Thromb Haemost. 2004; 2 (7) 1058-1070
- 63 O'Donnell M, Julian J, Kearon C. Risk of bleeding with vitamin K antagonists compared with low-molecular-weight heparin after orthopedic surgery: a rebuttal. J Thromb Haemost. 2005; 3 (3) 606-608 author reply 609-610
- 64 Lassen M R, Bauer K A, Eriksson B I, Turpie A G. European Pentasaccharide Elective Surgery Study (EPHESUS) Steering Committee . Postoperative fondaparinux versus preoperative enoxaparin for prevention of venous thromboembolism in elective hip-replacement surgery: a randomised double-blind comparison. Lancet. 2002; 359 (9319) 1715-1720
- 65 Turpie A G, Bauer K A, Eriksson B I, Lassen M R. PENTATHALON 2000 Study Steering Committee . Postoperative fondaparinux versus postoperative enoxaparin for prevention of venous thromboembolism after elective hip-replacement surgery: a randomised double-blind trial. Lancet. 2002; 359 (9319) 1721-1726
- 66 Turpie A G, Bauer K A, Eriksson B I, Lassen M R. Superiority of fondaparinux over enoxaparin in preventing venous thromboembolism in major orthopedic surgery using different efficacy end points. Chest. 2004; 126 (2) 501-508
- 67 Howard A W, Aaron S D. Low molecular weight heparin decreases proximal and distal deep venous thrombosis following total knee arthroplasty. A meta-analysis of randomized trials. Thromb Haemost. 1998; 79 (5) 902-906
- 68 Brookenthal K R, Freedman K B, Lotke P A, Fitzgerald R H, Lonner J H. A meta-analysis of thromboembolic prophylaxis in total knee arthroplasty. J Arthroplasty. 2001; 16 (3) 293-300
- 69 Bauer K A, Eriksson B I, Lassen M R, Turpie A G. Steering Committee of the Pentasaccharide in Major Knee Surgery Study . Fondaparinux compared with enoxaparin for the prevention of venous thromboembolism after elective major knee surgery. N Engl J Med. 2001; 345 (18) 1305-1310
- 70 Turpie A G, Bauer K A, Eriksson B I, Lassen M R. Fondaparinux vs enoxaparin for the prevention of venous thromboembolism in major orthopedic surgery: a meta-analysis of 4 randomized double-blind studies. Arch Intern Med. 2002; 162 (16) 1833-1840
- 71 Handoll H H, Farrar M J, McBirnie J, Tytherleigh-Strong G, Milne A A, Gillespie W J. Heparin, low molecular weight heparin and physical methods for preventing deep vein thrombosis and pulmonary embolism following surgery for hip fractures. Cochrane Database Syst Rev. 2002; (4) CD000305
- 72 Powers P J, Gent M, Jay R M et al.. A randomized trial of less intense postoperative warfarin or aspirin therapy in the prevention of venous thromboembolism after surgery for fractured hip. Arch Intern Med. 1989; 149 (4) 771-774
- 73 Borgstroem S, Greitz T, Van Der Linden W, Molin J, Rudics I. Anticoagulant prophylaxis of venous thrombosis in patients with fractured neck of the femur: a controlled clinical trial using venous phlebography. Acta Chir Scand. 1965; 129 500-508
- 74 Hamilton H W, Crawford J S, Gardiner J H, Wiley A M. Venous thrombosis in patients with fracture of the upper end of the femur. A phlebographic study of the effect of prophylactic anticoagulation. J Bone Joint Surg Br. 1970; 52 (2) 268-289
- 75 Eriksson B I, Bauer K A, Lassen M R, Turpie A G. Steering Committee of the Pentasaccharide in Hip-Fracture Surgery Study . Fondaparinux compared with enoxaparin for the prevention of venous thromboembolism after hip-fracture surgery. N Engl J Med. 2001; 345 (18) 1298-1304
- 76 Eriksson B I, Lassen M R. PENTasaccharide in HIp-FRActure Surgery Plus Investigators . Duration of prophylaxis against venous thromboembolism with fondaparinux after hip fracture surgery: a multicenter, randomized, placebo-controlled, double-blind study. Arch Intern Med. 2003; 163 (11) 1337-1342
- 77 Wirth T, Schneider B, Misselwitz F et al.. Prevention of venous thromboembolism after knee arthroscopy with low-molecular weight heparin (reviparin): Results of a randomized controlled trial. Arthroscopy. 2001; 17 (4) 393-399
- 78 Michot M, Conen D, Holtz D et al.. Prevention of deep-vein thrombosis in ambulatory arthroscopic knee surgery: a randomized trial of prophylaxis with low molecular weight heparin. Arthroscopy. 2002; 18 (3) 257-263
- 79 Camporese G, Bernardi E, Prandoni P et al.. Graduated compression stocking (GCS) versus low-molecular-weight heparin (LMWH) for prevention of deep vein thrombosis (DVT) after knee arthroscopy (KA): a randomized study (KANT). J Thromb Haemost. 2007; 5 (Suppl 2) OT-052
- 80 Ramos J, Perrotta C, Badariotti G, Berenstein G. Interventions for preventing venous thromboembolism in adults undergoing knee arthroscopy. Cochrane Database Syst Rev. 2007; (2) CD005259
- 81 Prandoni P, Falanga A, Piccioli A. Cancer and venous thromboembolism. Lancet Oncol. 2005; 6 (6) 401-410
- 82 Bergqvist D, Burmark U S, Flordal P A et al.. Low molecular weight heparin started before surgery as prophylaxis against deep vein thrombosis: 2500 versus 5000 XaI units in 2070 patients. Br J Surg. 1995; 82 (4) 496-501
- 83 ENOXACAN Study Group . Efficacy and safety of enoxaparin versus unfractionated heparin for prevention of deep vein thrombosis in elective cancer surgery: a double-blind randomized multicentre trial with venographic assessment. Br J Surg. 1997; 84 (8) 1099-1103
- 84 McLeod R S, Geerts W H, Sniderman K W Canadian Colorectal Surgery DVT Prophylaxis Trial investigators et al. Subcutaneous heparin versus low-molecular-weight heparin as thromboprophylaxis in patients undergoing colorectal surgery: results of the Canadian colorectal DVT prophylaxis trial: a randomized, double-blind trial. Ann Surg. 2001; 233 (3) 438-444
- 85 Clark-Pearson D L, DeLong E, Synan I S, Soper J T, Creasman W T, Coleman R E. A controlled trial of two low-dose heparin regimens for the prevention of postoperative deep vein thrombosis. Obstet Gynecol. 1990; 75 (4) 684-689
- 86 Clarke-Pearson D L, Synan I S, Dodge R, Soper J T, Berchuck A, Coleman R E. A randomized trial of low-dose heparin and intermittent pneumatic calf compression for the prevention of deep venous thrombosis after gynecologic oncology surgery. Am J Obstet Gynecol. 1993; 168 (4) 1146-1153 discussion 1153-1154
- 87 Clarke-Pearson D L, Coleman R E, Synan I S, Hinshaw W, Creasman W T. Venous thromboembolism prophylaxis in gynecologic oncology: a prospective, controlled trial of low-dose heparin. Am J Obstet Gynecol. 1983; 145 (5) 606-613
- 88 Agnelli G, Bergqvist D, Cohen A T, Gallus A S, Gent M. PEGASUS investigators . Randomized clinical trial of postoperative fondaparinux versus perioperative dalteparin for prevention of venous thromboembolism in high-risk abdominal surgery. Br J Surg. 2005; 92 (10) 1212-1220
- 89 Bergqvist D, Agnelli G, Cohen A T ENOXACAN II Investigators et al. Duration of prophylaxis against venous thromboembolism with enoxaparin after surgery for cancer. N Engl J Med. 2002; 346 (13) 975-980
- 90 Rasmussen M S, Jorgensen L N, Wille-Jørgensen P FAME Investigators et al. Prolonged prophylaxis with dalteparin to prevent late thromboembolic complications in patients undergoing major abdominal surgery: a multicenter randomized open-label study. J Thromb Haemost. 2006; 4 (11) 2384-2390
- 91 Kakkar V V, Balibrea J L, Martínez-González J, Prandoni P. CANBESURE Study Group . Extended prophylaxis with bemiparin for the prevention of venous thromboembolism after abdominal or pelvic surgery for cancer: the CANBESURE randomized study. J Thromb Haemost. 2010; 8 (6) 1223-1229
- 92 Mandalà M, Labianca R. European Society for Medical Oncology . Venous thromboembolism (VTE) in cancer patients. ESMO clinical recommendations for prevention and management. Thromb Res. 2010; 125 (Suppl 2) S117-S119
- 93 Ufer M. Comparative efficacy and safety of the novel oral anticoagulants dabigatran, rivaroxaban and apixaban in preclinical and clinical development. Thromb Haemost. 2010; 103 (3) 572-585
- 94 Coppola A, Tufano A, Cerbone A M, Di Minno G. Inherited thrombophilia: implications for prevention and treatment of venous thromboembolism. Semin Thromb Hemost. 2009; 35 (7) 683-694
- 95 Patnaik M M, Moll S. Inherited antithrombin deficiency: a review. Haemophilia. 2008; 14 (6) 1229-1239
- 96 Rodgers G M. Role of antithrombin concentrate in treatment of hereditary antithrombin deficiency. An update. Thromb Haemost. 2009; 101 (5) 806-812
- 97 Goldenberg N A, Manco-Johnson M J. Protein C deficiency. Haemophilia. 2008; 14 (6) 1214-1221
- 98 Amin A N, Stemkowski S, Lin J, Yang G. Preventing venous thromboembolism in US hospitals: are surgical patients receiving appropriate prophylaxis?. Thromb Haemost. 2008; 99 (4) 796-797
- 99 Cohen A T, Tapson V F, Bergmann J F ENDORSE Investigators et al. Venous thromboembolism risk and prophylaxis in the acute hospital care setting (ENDORSE study): a multinational cross-sectional study. Lancet. 2008; 371 (9610) 387-394
- 100 Kakkar A K, Davidson B L, Haas S K. Investigators Against Thromboembolism (INATE) Core Group . Compliance with recommended prophylaxis for venous thromboembolism: improving the use and rate of uptake of clinical practice guidelines. J Thromb Haemost. 2004; 2 (2) 221-227
- 101 Warwick D, Friedman R J, Agnelli G et al.. Insufficient duration of venous thromboembolism prophylaxis after total hip or knee replacement when compared with the time course of thromboembolic events: findings from the Global Orthopaedic Registry. J Bone Joint Surg Br. 2007; 89 (6) 799-807
- 102 Struijk-Mulder M C, Ettema H B, Verheyen C C, Büller H R. Comparing consensus guidelines on thromboprophylaxis in orthopedic surgery. J Thromb Haemost. 2010; 8 (4) 678-683
Antonio CoppolaM.D.
Regional Reference Centre for Coagulation Disorders, Federico II University Hospital
Via S. Pansini, 5 - 80131 Naples, Italy
eMail: antocopp@unina.it