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Leont'ev S.G.
Kafedra fakul'tetskoĭ khirurgii im. S.I. Spasokukotskogo Rossiĭskogo gosudarstvennogo meditsinskogo universiteta im. N.I. Pirogova, Moskva
Mironov A.V.
NII SP im. N.V. Sklifosovskogo
Gusev L.L.
City clinical hospital named after N.I. Pirogov, Moscow, Russia
Lebedev I.S.
Pirogov Russian National Research Medical University, Moscow, Russia;
Municipal Clinical Hospital No. 1 named after N.I. Pirogov, Moscow, Russia
Moskalenko E.P.
Kafedra fakul'tetskoĭ khirurgii Rossiĭskogo natsional'nogo issledovatel'skogo meditsinskogo universiteta im. N.I. Pirogova;
Gorodskaia klinicheskaia bol'nitsa #1 im. N.I. Pirogova
Kirienko A.I.
Russian National Research Medical University nabbed after N.I. Pirogov, Moscow, Russia
Andriiashkin V.V.
Kafedra fakul'tetskoĭ khirurgii im. S.I. Spasokukotskogo Rossiĭskogo gosudarstvennogo meditsinskogo universiteta im. N.I. Pirogova, Moskva
Prevention of recurrent deep vein thrombosis with intermediate-doses of low-molecular-weight heparin
Journal: Journal of Venous Disorders. 2013;7(2): 15‑20
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To cite this article:
Leont'ev SG, Mironov AV, Gusev LL, Lebedev IS, Moskalenko EP, Kirienko AI, Andriiashkin VV. Prevention of recurrent deep vein thrombosis with intermediate-doses of low-molecular-weight heparin. Journal of Venous Disorders. 2013;7(2):15‑20. (In Russ.)
Aim. The objective of the present study was to estimate the effectiveness and safety of the prevention of a relapse of deep venous thrombosis in the lower extremities using intermediate doses of low molecular weight heparins (LMWH) in comparison with standard therapy with the use of vitamin K antagonists (VKA). Material and methods. This comparative prospective non-randomized study included 106 patients presenting with deep venous thrombosis (DVT). They were allocated to two groups. Those comprising the study group (n=56) were prescribed LMWH at intermediate doses while the patients of the control group (n=50) were given the standard prophylactic treatment with the use of VKA. The results of the treatment were evaluated within 1, 3, and 6 months from the onset of pharmacotherapy. Results. One (1.8%) patient of the study group developed a relapse of DVT within 1 month after the beginning of observation. One case (2%) of relapse of thromboembolic complications was documented in the control group; it required hospitalization of the patient. There were no cases of pulmonary embolism among the patients of either group. One (1.8%) case of post-prophylactic complication (an allergic reaction to the heparin preparation) was documented in the group of patients treated with intermediate doses of LMWH. Three (6%) patients of the control group experienced hemorrhagic complications (macrohematuria and spontaneous retroperitoneal hematoma). No such complications were recorded in the study group. The effectiveness of the prophylactic treatment was estimated based on the characteristics of the patients' quality of life. The questionnaire study failed to demonstrate statistical differences between the quality of life indices depending on the pharmacotherapeutic modalities employed in the present study. Conclusion. The effects of intermediate doses of LMWH and VKA are comparable in terms of clinical effectiveness even though the prescription of LMWH at intermediate doses should be regarded as a safer therapeutic modality. We believe that the main criterion for the choice of an anticoagulant for long-term prophylaxis should be the risk of development of hemorrhage.
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Leont'ev S.G.
Kafedra fakul'tetskoĭ khirurgii im. S.I. Spasokukotskogo Rossiĭskogo gosudarstvennogo meditsinskogo universiteta im. N.I. Pirogova, Moskva
Mironov A.V.
NII SP im. N.V. Sklifosovskogo
Gusev L.L.
City clinical hospital named after N.I. Pirogov, Moscow, Russia
Lebedev I.S.
Pirogov Russian National Research Medical University, Moscow, Russia;
Municipal Clinical Hospital No. 1 named after N.I. Pirogov, Moscow, Russia
Moskalenko E.P.
Kafedra fakul'tetskoĭ khirurgii Rossiĭskogo natsional'nogo issledovatel'skogo meditsinskogo universiteta im. N.I. Pirogova;
Gorodskaia klinicheskaia bol'nitsa #1 im. N.I. Pirogova
Kirienko A.I.
Russian National Research Medical University nabbed after N.I. Pirogov, Moscow, Russia
Andriiashkin V.V.
Kafedra fakul'tetskoĭ khirurgii im. S.I. Spasokukotskogo Rossiĭskogo gosudarstvennogo meditsinskogo universiteta im. N.I. Pirogova, Moskva
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