Low-Dose Heparin and Deep-Vein Thrombosis after Total Hip Replacement

P. M Mannucci; Luisa E. Citterio; N Panajotopoulos

doi:10.1055/s-0038-1648020

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 1976; 36(01): 157-164
DOI: 10.1055/s-0038-1648020

Original Article

Schattauer GmbH

Low-Dose Heparin and Deep-Vein Thrombosis after Total Hip Replacement

P. M Mannucci

¹Haemophilia and Thrombosis Centre Angelo Bianchi Bonomi, University of Milano, 3rd Institute of Clinical Medicine, University of Milano; Orthopedic Hospital Gaetano Pini, Milano, Italy

,

Luisa E. Citterio

¹Haemophilia and Thrombosis Centre Angelo Bianchi Bonomi, University of Milano, 3rd Institute of Clinical Medicine, University of Milano; Orthopedic Hospital Gaetano Pini, Milano, Italy

,

N Panajotopoulos

¹Haemophilia and Thrombosis Centre Angelo Bianchi Bonomi, University of Milano, 3rd Institute of Clinical Medicine, University of Milano; Orthopedic Hospital Gaetano Pini, Milano, Italy

› Institutsangaben

Abstract

Summary

The effect of subcutaneous low-dose heparin on postoperative deep-vein thrombosis (D. V. T.) (diagnosed by the ¹²⁵I-labelled fibrinogen test) has been investigated in a trial of 143 patients undergoing the operation of total hip replacement. Two randomized studies were carried out: in one the scanning for D.V.T. was carried out daily for 7 days post operatively and in the other for 15 days. In both, the incidence of D.V.T. was significantly lower in the heparin-treated patients (P<0.005). Bilateral D.V.T. was also prevented (P<0.05), through the extension of D.V.T. to the distal veins of the thigh was not significantly reduced. Heparin treatment was, however, followed by a higher incidence of severe postoperative bleeding (P< 0.02) and wound haematoma formation (P< 0.005), and the postoperative haemoglobin was significantly lower than in the control group (P<0.005). A higher number of transfused blood units was also needed by the heparin treated patients (P<0.001).

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Referenzen

References
1 Coventry M. D, Nolan R. N, Beckenbaugh R. D. 1973; Delayed prophylactic anticoagulation: a study of results and complications in 2.012 total hip arthroplasties. Journal of Bone and Joint Surgery 55: 1487.
2 Crawford W. J, Hillman F, Charnley J. 1968. A clinical trial of prophylactic anticoagulant therapy in elective hip surgery. Centre for Hip Surgery. Wrightington Hospital; Internal Publication no. 14.
3 Evarts C. M, Feil A. J. 1971; Prevention of thromboembolic disease after elective surgery of the hip. Journal of Bone and Joint Surgery 53-A: 1271.
4 Field E. S, Nicolaides A. N, Kakkar V. V, Crellin R. Q. 1972; Deep-vein thrombosis in patients with fractures of the femoral neck. British Journal of Surgery 59: 377.
5 Gallus A. S, Hirsh J, Tuttle R. J, Trebilcock R, O’Brien S.E, Carrol J. J, Minden J. M, Hudecki S. M. 1973; Small subcutaneous doses of heparin in prevention of venous thrombosis. New England Journal of Medicine 288: 545.
6 Hampson W. G. J, Harris F. C, Incas H. K, Roberts P. M, McCall I. W, Jackson P. C, Powell N. L, Staddon G. E. 1974; Failure of low-dose heparin to prevent deep-vein thrombosis after hip replacement arthroplasty. Lancet 2: 795.
7 Harris W. H, Salzman E. W, Athanasoulis C, Waltman A. C, Baum S, De Sanctis R. 1974; Comparison of warfarin, low-molecular-weight dextran, aspirin and subcutaneous heparin in prevention of venous thrombosis. Journal of Bone and Joint Surgery 56-A: 1552.
8 Harris W. H, Salzman E. W, Athanasoulis C, Waltman A, Baum S, De Sanctis R, Potsaid M. J, Size H. 1975; Comparison of ¹²⁵I fibrinogen count scanning with phlebography for detection of venous thrombi after elective hip surgery. New England Journal of Medicine 292: 665.
9 Kakkar V. V, Nicolaides A. N, Renney J. T, Friend J. R, Clarke M. B. 1970; ¹²⁵I labelled fibrinogen test adapted for routine screening for deep-vein thrombosis. Lancet 2: 540.
10 Kakkar V. V, Corrigan T, Spindler J, Fossard D. P, Flute P. T, Creliin R. Q, Wessler S, Yin E. T. 1972; Efficacy of low doses of heparin in prevention of deep-vein thrombosis after major surgery. Lancet 2: 101.
11 International Multicentre Trial. 1975; Prevention of fatal post-operative pulmonary embolism by low doses of heparin. Lancet 2: 45.
12 Morris G. K, Henry A. P. J, Preston B. J. 1974; Prevention of deep-vein thrombosis by low-dose heparin in patients undergoing total hip replacement. Lancet 2: 797.