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Thromboembolism after hip surgery.

K Westermann, O Trentz, P Pretschner

    International Orthopaedics
    |January 1, 1981
    PubMed
    Summary
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    The combination of low-dose heparin and dihydroergotamine effectively prevents deep venous thrombosis and pulmonary embolism in high-risk patients, significantly reducing complications without increasing fatal outcomes.

    Area of Science:

    • Vascular Surgery
    • Pharmacology
    • Thrombosis Research

    Background:

    • Deep venous thrombosis (DVT) and pulmonary embolism (PE) are significant risks for high-risk surgical patients.
    • Prophylaxis is crucial to reduce morbidity and mortality associated with these thromboembolic events.

    Purpose of the Study:

    • To evaluate the efficacy of various antithrombotic agents in preventing DVT and PE.
    • To identify the optimal prophylactic regimen for high-risk surgical patients.

    Main Methods:

    • A prospective trial involving 386 high-risk patients.
    • Comparison of five antithrombotic strategies: aspirin/dipyridamol, dextran 60, dihydroergotamine, low-dose heparin, and a combination of dihydroergotamine and low-dose heparin.
    • Diagnostic investigations included I125 fibrinogen uptake test, phlebography, and lung scan.

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    Main Results:

    • The combination of low-dose heparin and dihydroergotamine significantly reduced thromboembolic complications (15% incidence) compared to other agents.
    • No pulmonary emboli were observed in the dihydroergotamine and low-dose heparin group.
    • While effective, administering this combination three times daily did not improve outcomes but increased hemorrhagic complications.

    Conclusions:

    • The combination of low-dose heparin and dihydroergotamine is a highly effective prophylactic strategy against DVT and PE in high-risk patients.
    • This combination has demonstrated success in preventing fatal pulmonary emboli, particularly in the context of total hip replacement surgery.
    • Optimizing the dosing regimen is important to balance efficacy and minimize adverse events like hemorrhage.