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IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
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The external iliac artery transitions out of the body cavity, entering the femoral region of the lower leg, and is renamed the femoral artery at the point where it traverses the body wall. This artery is responsible for the distribution of blood to the thigh's deep muscles and the skin's ventral and lateral regions, achieved through several minor branches and the lateral deep femoral artery, which also spawns a lateral circumflex artery. The knee area receives blood from the genicular...
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The human body consists of an intricate network of veins responsible for the crucial task of blood drainage from the lower limbs. These veins can be categorized into two main types: deep veins and superficial veins.
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The human circulatory system, a marvel of biological engineering, is a complex network of vessels that transport blood throughout the body. Among these, the veins responsible for carrying blood from the upper limbs are divided into two categories: deep and superficial.
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Related Experiment Video

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Intravenous tranexamic acid and lower limb arthroplasty-a randomised controlled feasibility study.

T W Painter1, D J Daly2, R Kluger3

  • 1Clinical Senior Lecturer, Discipline of Acute Care Medicine, Adelaide Medical School, University of Adelaide; Adelaide, South Australia.

Anaesthesia and Intensive Care
|July 3, 2018
PubMed
Summary

Intravenous tranexamic acid (TA) significantly reduced blood transfusions in patients undergoing lower limb arthroplasty. This feasibility study supports a larger trial to confirm TA

Keywords:
arthroplastyfeasibilityquality of lifetranexamic acid: arthroplastytransfusion

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Area of Science:

  • Orthopedic Surgery
  • Anesthesiology
  • Hematology

Background:

  • Tranexamic acid (TA) is recognized for reducing bleeding and transfusion needs in orthopedic surgery.
  • Limited evidence exists on TA's impact on rare adverse events and patient-centered outcomes in lower limb arthroplasty.
  • A large-scale randomized controlled trial (RCT) is needed to fully evaluate TA's efficacy and safety in this patient population.

Purpose of the Study:

  • To assess the feasibility of conducting a large-scale RCT on intravenous (IV) tranexamic acid (TA) for lower limb arthroplasty.
  • To evaluate the effectiveness of IV TA in reducing allogeneic blood transfusions in patients undergoing hip or knee replacement.
  • To explore the impact of TA on adverse clinical and surgical events and patient-reported outcomes.

Main Methods:

  • A prospective, randomized, double-blind, placebo-controlled trial involving 140 patients aged 45+ undergoing elective hip or knee arthroplasty.
  • Participants received either IV TA or a placebo.
  • Primary endpoints included transfusion rates and feasibility metrics; secondary endpoints covered adverse events and patient questionnaires.

Main Results:

  • Allogeneic red blood cell transfusion was required in 15% of patients before hospital discharge.
  • The TA group showed significantly lower transfusion rates (8.5%) compared to the placebo group (21.7%, P=0.03).
  • Three of four feasibility endpoints were met, though patient recruitment was slower than anticipated. No significant differences in secondary outcomes were observed.

Conclusions:

  • Intravenous tranexamic acid effectively reduced blood transfusion requirements in patients undergoing lower limb arthroplasty.
  • The study methodology is feasible for a larger multicenter trial to definitively assess TA's safety and efficacy.
  • Further research is warranted to confirm these findings and explore patient-centric benefits.