Search published articles


Showing 3 results for Venous Thromboembolism
Dabigatran etexilate, a novel oral direct thrombin inhibitor, for preventing thromboembolic events after knee replacement arthroplasty
Moghtadaee M, Shahhoseini Gh, Farahini H, Yegane A, Rajabpour S,
Volume 69, Issue 11 (2-2012)
Abstract

Background: Dabigatran etexilate is one of the few direct thrombin inhibitors with anti-coagulant activities and the following distinctive features: taken orally, no need to closely monitor for complications, and no need for regular dose adjustments. Relying on the above mentioned valuable advantages, dabigatran etexilate can be considered as a premier choice for the prevention of venous thromboembolism after knee replacement arthroplasty.

Methods: Forty five patients undergoing 50 knee replacement surgeries were included in this case-series study undertaken in Hazrat Rasool Akram and Khatam-alanbia Hospitals during 2010. Dabigatran etexilate was administered for the prevention of venous thromboembolism after knee arthroplasty in doses of 110 mg in the first 1-4 h after surgery followed by daily doses of 220 mg for 10 days. Patients were examined 3 times and a color Doppler sonography was performed on the 11th day to check for venous thrombosis. Finally, the patients were re-examined at the end of the 1st and the 3rd months postoperatively.

Results: Only one out of 45 patients was diagnosed to have venous thrombosis on sonography done on the 11th day but the patient did not have any symptoms and repeat sonographies at the end of the 1st and the 3rd months postoperatively showed no venous thrombosis either. No complications were witnessed in the patients in the 3-month follow-up period.

Conclusion: Dabigatran etexilate (220 mg/d for 10 days) can be an effective drug against venous thrombosis after total knee replacement surgeries.


Epidemiology, diagnosis and treatment of pulmonary thromboembolism: review article
Yaser Jenab, Kaveh Hosseini,
Volume 78, Issue 9 (12-2020)
Abstract
High incidence and mortality rate of pulmonary thromboembolism urge physicians to be aware of its occurrence and treatment. Pulmonary thromboembolism (PE) typically manifests itself with acute dyspnea and tachycardia and may occur along with deep vein thrombosis. However, syncope, chest pain and heart failure decompensation in previously stable patients might be another presenting signs and symptoms.  Although there are several guidelines about PE prophylaxis both in medical and surgical patients, guideline adherence is not good enough. The most important reasons are; inappropriate PE risk scoring, insufficient prophylaxis dosage and the fear of probable bleeding. Both unfractionated and low-molecular-weight heparin has been suggested as prophylactic agents. The role of echocardiography in the diagnosis of PE has been challenged; however, it is mandatory to do an echocardiogram to define the prognosis and also the proper treatment approach. Based on the severity of right ventricular dysfunction, biomarker levels and hemodynamic status of the patients, they will be categorized as low, moderate and high-risk. Moderate to high risk patients should be planned for more invasive treatments such as thrombolytic therapy. In conclusion, PE is the third common cardio-vascular acute condition after myocardial infarction and cerebrovascular accident. The most important reason for death in PE is right-side heart failure. Besides, PE is the most preventable fatal disease in hospitalized patients. Long hospital stay, inappropriate thromboembolic prophylaxis and baseline comorbidities predispose patients to this fatal event. Sometimes, the fear of probable bleeding precludes guideline-based thromboprophylaxis, especially in post-operative patients. If PE occurs; it will be hard to manage and treat. New oral anticoagulants are advised as fixed-dose which does not need to be closely monitored. Drug and food interaction is significantly lower in New oral anticoagulants (NOACs). Thrombo-prophylaxis is better than mechanical thrombo-prophylaxis. Post-discharge thromboprophylaxis is also advised in orthopedic patients. It is mandatory to advise patients to walk after discharge and avoid long-term bedrest if possible. A too early discharge may also be an important risk factor and prone patients to PE at home.

Rivaroxaban versus enoxaparin for treatment of patients with nonhematologic cancer with venous thromboembolism a randomized clinial trial
Seyed Hamid Borsi, Hanieh Raji, Mehrdad Dargahi Malamir , Forogh Nokhostin, Afrooz Kargaran,
Volume 79, Issue 4 (7-2021)
Abstract
Background: Low-Molecular-Weight Heparin (LMWH) is recommended as the first-line treatment in patients with active cancer and venous thromboembolism (VTE), but many patients prefer to take oral anticoagulants and non-injectable forms with more reasonable price. Venous thromboembolism is a very common comorbidity in patients with cancer. Therefore, the aim of this study was to evaluate the efficacy and safety of the rivaroxaban compared with enoxaparin in patients with cancer and VTE.
Methods: This randomized clinical trial was conducted on 50 patients with non-hematologic cancer and deep vein thrombosis (DVP) or pulmonary thromboembolism (PTE) enrolled into Imam Khomeini hospital, from November 2019 to March 2020 in Ahvaz. The participants randomly assigned in two treatment groups (25 patients in each group) of rivaroxaban (15 mg every 12 hours for the first three weeks and then orally at 20 mg daily) or enoxaparin (1 mg/kg by subcutaneous injection every 12 hours) and followed for 6 months to evaluate the efficacy, complications and safety (incidence of recurrent VTE, major bleeding and deaths) of these therapies in Ahvaz.
Results: The three most common cancer diagnoses were breast (n=11, 22%), colon (n=10, 20%), and lung (n=7, 14%). Major bleeding at 6 months was only seen in one patient (4%) in the enoxaparin group and did not occur in the rivaroxaban group (P>0.05). Minor bleeding occurred in 1 patient (4%) in the rivaroxaban group and did not occur in the enoxaparin group (P>0.05). One patient in the enoxaparin group died because of fever and neutropenia. The prevalence of DVT and PTE in cancer patients was not significantly different based on patient age (P=0.154), gender (P=0.430), BMI (P=0.490), underlying disease (P=0.294), smoking (P=0.955), type of cancer (P=0.527), and metastatic cancer (P=0.280).
Conclusion: The results of this study suggest that the efficacy of rivaroxaban is not less than that of enoxaparin and therefore can be a potential option for patients with non-hematologic cancer and VTE. However, further randomized, controlled trials are needed to confirm these results.
 

Page 1 from 1     

© 2025 , Tehran University of Medical Sciences, CC BY-NC 4.0

Designed & Developed by : Yektaweb