Prophylaxis of Deep Venous Thrombosis with a Low-Molecular-Weight Heparin (Kabi 2165/Fragmin®) in Stroke Patients

Abstract

In a group of 60 patients in the acute phase of an ischemic stroke the assumption that low-molecular-weight heparin Kabi 2165 in the dose of 2 × 2,500 anti-Xa units s.c. could prevent thromboembolic complications was tested using a double-blind, placebo-controlled, randomized trial design. Thirty patients were allocated to each group. Both treatment groups were comparable with regard to neurological status and general condition. In the Kabi 2165 group there were 6 cases of deep venous thrombosis (DVT) compared to 15 in the placebo group (p = 0.05). In the placebo group there were 4 deaths during the trial versus 9 in the Kabi-2165-treated group (NS). Cerebral bleeding complicated 2 cases in the placebo group versus 4 in the Kabi 2165 group (NS). These results indicate that in ischemic stroke patients Kabi 2165 2 × 2,500 anti-Xa units s.c./24 h reduces the frequency of DVT. Because of the small number of patients it is impossible to evaluate the safety.

Efficacy and Safety of Anticoagulant Treatment in Acute Cardioembolic Stroke

“…After scanning titles and abstracts, 743 citations were excluded and 23 were retained for further evaluation. Eighteen studies were excluded for the following reasons: data on cardioembolic strokes were not reported in 9 trials 8 -16 ; one trial did not have a control group 17 ; 2 trials were nonrandomized 18,19 ; randomization was performed after 48 hours from onset in 2 trials 20,21 ; cardioembolic strokes were excluded in 3 trials [22][23][24] ; and no computed tomography scan before randomization was performed in one trial. 25 Two studies were reincluded in the analysis because the authors provided us with data on cardioembolic strokes not previously reported in the original published articles.…”

Toward the individual approach to the evaluation of risks and prevention of postoperative venous thromboembolism

“…Но если взглянуть на абсолютные цифры, зарегистрированные в опыт ных группах на фоне применения изучаемых мето дик, то они могут варьировать в широких пределах, подчеркивая гетерогенность выборки, а их среднее значение далеко от идеального уровня. Так, у лиц с острым нарушением мозгового кровообращения, сопровождающимся парезами и параличами ниж них конечностей, частота верификации ВТ на фоне стандартной профилактики, включающей эластич ную компрессию, интермиттирующую пневмоком прессию, прямые антикоагулянты, находится в ин тервале 4-23% со средним значением 11,6% [17][18][19][20][21][22][23][24][25]. При хирургическом лечении онкологических заболеваний частота развития ВТ составляет 6,25-55,5% (в среднем 15,9%) на фоне применения анти коагулянтов и компрессионной терапии [26][27][28][29][30][31][32][33][34][35][36].…”

Care of the Stroke Patient: Routine Management to Lifesaving Treatment Options

“…The rate of discovering a deep venous thrombosis (DVT) is also directly dependent on the screening test used and on whether the test was obtained based on clinical suspicion or not. For example, using I 125 fibrinogen scanning, the rate of DVT ranges from 30 to 80%, to as low as 5% using Doppler ultrasound [14,15]. Even in patients who were treated with thomboprophylaxis, the incidence of VTE can be significant.…”