[Desirudin (Revasc) to prevent thromboembolic complications after hip or knee replacement surgery]

Since March 1999, desirudin (REVASC), a recombinant hirudin, has been used in Nancy to treat patients who undergo total hip or knee replacement with a high risk of thromboembolic complications. We carried out a retrospective study using clinical data on the first 15 consecutive patients treated with desirudin to find out prescription motivations, type of shift (indirect anticoagulants or low-molecular-weight-heparin) and evolution. They all had a high risk of deep vein thrombosis (thrombophily, obesity, history of thromboembolic events). Some of this patients would have been excluded of the studies which permitted desirudin to be approved. In this study, we found no thromboembolic complications. The only striking facts are one bleeding complication (after difficult surgery) and one pulmonary embolism (2 months later).