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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
Published on: February 10, 2023
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Postorthopedic Surgery Joint Replacement Surgery Venous Thromboembolism Prophylaxis.
Louis M Kwong1, Jon A Kimball2
1Department of Orthopaedic Surgery, Harbor-UCLA Medical Center, 1000 West Carson Street, Box 422, Torrance, CA 90509, USA.
Hematology/Oncology Clinics of North America
|September 18, 2016
Summary
Elective joint replacement surgery increases risk for venous thromboembolism (VTE). Novel oral anticoagulants like rivaroxaban and apixaban are safe and more effective VTE prevention than enoxaparin.
Area of Science:
- Orthopedic Surgery
- Pharmacology
- Hematology
Background:
- Elective total hip or knee arthroplasty is associated with a significant risk of venous thromboembolism (VTE).
- Understanding the pathophysiology of VTE post-arthroplasty has led to the development of targeted pharmacologic strategies.
- Various risk reduction strategies have been employed to mitigate VTE incidence.
Purpose of the Study:
- To evaluate the safety and efficacy of novel oral anticoagulants (NOACs) for VTE prophylaxis after joint arthroplasty.
- To compare the effectiveness of NOACs against traditional anticoagulants like enoxaparin.
- To address ongoing controversies regarding optimal VTE pharmacoprophylaxis in this patient population.
Main Methods:
- Review of pharmacologic strategies targeting the coagulation cascade for VTE prevention.
- Analysis of Food and Drug Administration approvals for rivaroxaban (2011) and apixaban (2014) as new oral antithrombotic agents.
- Comparative assessment of NOACs versus enoxaparin in VTE risk reduction.
Main Results:
- Novel oral anticoagulants, including rivaroxaban and apixaban, have been approved for VTE prophylaxis.
- This class of anticoagulants has demonstrated a favorable safety profile.
- NOACs have shown superior effectiveness in preventing VTE compared to enoxaparin.
Conclusions:
- Novel oral anticoagulants represent a safe and effective option for VTE prophylaxis following elective total hip or knee arthroplasty.
- While controversies persist, NOACs offer an improved therapeutic option over enoxaparin for post-arthroplasty VTE prevention.
- Continued research and clinical evaluation are important for defining the ideal VTE pharmacoprophylactic agent.
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