Unexpectedly High Rate of Phlebographic Deep Venous Thrombosis Following Elective General Abdominal Surgery Among Patients Given Prophylaxis With Low-Molecular-Weight Heparin

Henri Bounameaux, MD; Olivier Huber, MD; Ebrahim Khabiri, MD; Pierre-Alain Schneider, MD; Dominique Didier, MD; Adrien Rohnei, MD
Arch Surg. 1993;128(3):326-328. doi:10.1001/archsurg.1993.01420150082015.
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• One hundred ninety-four patients undergoing elective general abdominal surgery were randomized in a single-blind study to receive one daily subcutaneous injection of a low-molecular-weight heparin, dalteparin sodium (2500 IU, n=97) or nadroparin calcium (3075 IU, n=97), two regimens that are approved in Europe to prevent deep venous thrombosis. On the eighth postoperative day, bilateral ascending leg phlebography (n=185) showed the presence of deep venous thrombosis in 45 cases (24.3%; 95% confidence interval, 18% to 31%), with a significantly higher rate (on intention-to-treat) among the patients who received the lower dosage (30 vs 15 deep venous thromboses). We conclude that the two regimens of low-molecular-weight heparin that were used in this study failed to prevent postoperative phlebographically proved deep venous thrombosis in one of four patients.

(Arch Surg. 1993;128:326-328)


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