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Prevention of deep venous thrombosis in orthopedic surgery: effects of defibrotide

R Zanasi1, G Fioretta, G Ciocia

  • 1Orthopedics Department, Fatebenefratelli Hospital, Milan, Italy.

Clinical Therapeutics
|January 1, 1988
PubMed

Insights

Defibrotide showed a promising trend in preventing symptomatic deep venous thrombosis (DVT) and pulmonary embolism after orthopedic surgery compared to calcium heparin and aspirin (ASA). This suggests defibrotide is a viable alternative for DVT prophylaxis.

Area of Science:

  • Orthopedic Surgery
  • Vascular Medicine
  • Pharmacology

Background:

  • Deep venous thrombosis (DVT) is a significant risk following orthopedic surgery.
  • Current prophylactic measures include calcium heparin and acetylsalicylic acid (ASA).
  • Novel therapeutic strategies are being explored to improve DVT prevention.

Purpose of the Study:

  • To compare the efficacy of defibrotide against calcium heparin and ASA in preventing DVT post-orthopedic surgery.
  • To evaluate the incidence of symptomatic DVT and pulmonary embolism in patients receiving different prophylactic treatments.

Main Methods:

  • A randomized controlled trial involving 63 patients undergoing hip or other orthopedic surgery.
  • Patients were assigned to receive defibrotide, calcium heparin, or ASA for DVT prophylaxis.
  • Fibrinogen uptake tests were used for daily monitoring, alongside clinical assessment for DVT and pulmonary embolism.

Main Results:

  • No significant difference in fibrinogen uptake was observed across the three treatment groups.
  • Defibrotide demonstrated a trend towards lower rates of symptomatic DVT (1/19) compared to calcium heparin (2/25) and ASA (4/19).
  • Defibrotide showed no cases of pulmonary embolism, while calcium heparin had one and ASA had two.

Conclusions:

  • Defibrotide therapy presents a valid alternative for deep venous thrombosis prophylaxis in orthopedic surgery patients.
  • The findings suggest a potential benefit of defibrotide in reducing symptomatic DVT and pulmonary embolism.
  • Further research may be warranted to confirm the efficacy of defibrotide in this patient population.

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