Prevention of venous thromboembolism with aspirin following knee surgery: A systematic review and meta-analysis

Marrannes, Stephanie; Victor, Klaas; Arnout, Nele; Backer, Tine De; Victor, Jan; Tampere, Thomas

doi:10.1302/2058-5241.6.200120

Cited by 7 publications

(15 citation statements)

References 73 publications

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“…La RS más actual y con el mayor número de estudios incluidos [10] tuvo 32 de 50 ECA, un (64 %) del total para ser elegibles de acuerdo a los criterios de selección del trabajo. Se exploró si esta revisión excluyó explícitamente estos estudios o si hubo criterios adicionales que explicaran por qué no se incluyeron.…”

Section: Resultsunclassified

Uso de aspirina en pacientes sometidos a artroplastia total de rodilla

Oyarce¹,

Vega²,

Arriagada³

et al. 2023

Preprint

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Section: Resultsunclassified

Uso de aspirina en pacientes sometidos a artroplastia total de rodilla

Oyarce¹,

Vega²,

Arriagada³

et al. 2023

Preprint

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“…Therefore, when using LMWH for thrombosis prevention, clinicians should closely monitor the changes in Hb decline and post-treatment drainage volume in patients, promptly replenish blood volume according to the patient condition, and provide other symptomatic supportive treatments. As indicated in the meta-analysis carried out by Marannes et al [ 35 ], Xa I was more effective than ASA, LMWH, and warfarin on preventing VTE after TKA, but it was associated with a significantly increased bleeding complication rate. Zou et al [ 18 ] compared the efficacy and safety of ASA, RA, and LMWH in the prevention of DVT after TKA.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of different antithrombotic agents in combination with tranexamic acid for venous thromboembolism prophylaxis and blood management after total knee replacement: a prospective randomized study

Zhou

Wang

Zhang

et al. 2023

BMC Musculoskelet Disord

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Background Tranexamic acid (TXA) has been widely applied in total knee arthroplasty (TKA) to significantly reduce perioperative blood loss and improve knee function recovery in patients after surgery. The choice of antithrombotic agents for venous thromboembolism (VTE) prevention after TKA is controversial. Therefore, this study aimed to compare the effects of different antithrombotic agents on patients after primary unilateral TKA in the context of applied TXA. Methods A total of 180 patients undergoing primary unilateral TKA from October 2020 to December 2021 were included in this study. All patients were given an intraoperative drip of 60 mg/kg TXA. Thereafter, patients were divided into three groups (n = 60 each). Baseline data were comparable among the three groups. The average follow-up time was 3.02 ± 0.09 months. Group 1 enrolled patients receiving oral rivaroxaban (RA) at 10 mg, Group 2 included patients who received subcutaneous Dalteparin sodium at 2500 IU, while Group 3 included patients taking oral aspirin (ASA) at 100 mg. Patients in all the three groups received treatment once a day for 30 days at 12 h postoperatively. The primary outcomes in this study were post-treatment drainage volume and thrombotic complication rate. The secondary outcomes included hematologic parameters, transfusion rate, intraoperative blood loss, total blood loss (TBL), and bleeding complication rate. Results The average drainage volume after treatment was significantly lower in Group 3 than in Group 1 and Group 2 (205.2 ± 69.0 vs 243.4 ± 72.5 vs 295.4 ± 72.5 ml, P < 0.001), and there was a significant difference between Group 1 and Group 2 (243.4 ± 72.5 mL vs 295.4 ± 72.5 mL, P < 0.001). The blood transfusion rate of Group 2 dramatically increased compared with Group 1 and Group 3 (20.0% vs 6.7% vs 5.0%, P = 0.01). The bleeding complication rate in Group 1 apparently increased relative to Group 2 and Group 3 (26.7% vs 10.0% vs 8.3%, P = 0.008). Besides, there was no significant difference in the thrombotic complication rate among the three groups. Conclusion Under the background of TXA application, ASA, RA, and Dalteparin sodium were all effective on preventing VTE after TKA. In addition, ASA effectively reduced post-treatment Hemoglobin (Hb) loss, drainage volume, TBL, transfusion rate, and bleeding complications compared with RA and Dalteparin sodium. Trial registration The trial was registered at the Chinese Clinical Trial Registry (ChiCTR2200060169). Date of Registration: 21/05/2022.

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“…81,83 Marrannes et al in their meta-analysis did not find a significant difference in DVT/PE rates following TKA based on dosage differences in aspirin. 84 In relation to VTE prophylaxis in patients weighing 120 kg, a higher dose of aspirin (320 mg twice daily) was shown to result in over 60% reduction in VTE incidence up to 6 months following surgery, when compared with 81 mg twice daily. 85 However, another smaller study showed no difference in 90-day VTE rates with either of these doses between BMI categories.…”

Section: Doacsmentioning

confidence: 99%

“…81 83 Marrannes et al in their meta-analysis did not find a significant difference in DVT/PE rates following TKA based on dosage differences in aspirin. 84…”

Section: Pharmacological Thromboprophylaxis In Obesity: Dosing Princi...mentioning

confidence: 99%

Obesity and the Risk of Venous Thromboembolism after Major Lower Limb Orthopaedic Surgery: A Literature Review

et al. 2022

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The risk of venous thromboembolism following total joint arthroplasty is significantly greater than those of other types of elective orthopaedic procedures. This risk is increased in obesity due to the associated prothrombotic physiological and hematological changes that predispose to embolic events. The prevalence of obesity is increasing in the aging population, which contributes to a further increase in the risk of postoperative thrombosis in the older patients. There is a lack of clear evidence regarding dosing information for thromboprophylaxis medications in patients with obesity. As a result, the currently available thromboprophylaxis guidelines do not provide specific recommendations for this group. Suboptimal dosing regimens for these medications can place these patients at a risk of bleeding or clotting complications postsurgery. Hence any increase in dosage may require intensive surveillance for the residual anticoagulant effects and careful balancing of risks and benefits on an individual basis. Our review discusses the basis for increased thrombotic risk in obesity, the evidence supporting dosage recommendations, and the implications of the current guidelines for pharmacological thromboprophylaxis in patients with obesity undergoing lower limb arthroplasty.

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Prevention of venous thromboembolism with aspirin following knee surgery: A systematic review and meta-analysis

Cited by 7 publications

References 73 publications

Uso de aspirina en pacientes sometidos a artroplastia total de rodilla

Uso de aspirina en pacientes sometidos a artroplastia total de rodilla

Effectiveness of different antithrombotic agents in combination with tranexamic acid for venous thromboembolism prophylaxis and blood management after total knee replacement: a prospective randomized study

Obesity and the Risk of Venous Thromboembolism after Major Lower Limb Orthopaedic Surgery: A Literature Review

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