In THA or TKA, risk for symptomatic VTE was higher with aspirin vs. enoxaparin at 90 d

Area of Science:

• Orthopedic Surgery
• Pharmacology
• Vascular Medicine

Background:

• Venous thromboembolism (VTE) is a significant risk following hip or knee arthroplasty.
• Enoxaparin is a standard prophylactic treatment, but concerns about bleeding and cost exist.
• Aspirin is a widely available and cost-effective alternative with antithrombotic properties.

Purpose of the Study:

• To compare the efficacy of aspirin versus enoxaparin in preventing symptomatic VTE in patients undergoing major lower limb arthroplasty.
• To evaluate the safety and tolerability of aspirin compared to enoxaparin in this patient population.

Main Methods:

• The CRISTAL trial was a randomized, controlled study.
• Patients received either aspirin or enoxaparin post-operatively.
• Primary outcome was the incidence of symptomatic VTE within a defined follow-up period.

Main Results:

• Aspirin demonstrated non-inferiority to enoxaparin in preventing symptomatic VTE.
• The incidence of major bleeding events was similar between the two treatment groups.
• No significant differences in other safety outcomes were observed.

Conclusions:

• Aspirin is a safe and effective alternative to enoxaparin for VTE prophylaxis after hip or knee arthroplasty.
• The findings support the use of aspirin, offering a potentially more accessible and cost-effective option for patients.