The Application of Different Groups of Medications for the Pharmacological Prevention of Thromboembolism After Major Orthopaedic Surgery in the Clinical Practice

Kasimova A.R.; Bozhkova S.A.

doi:https://doi.org/10.17116/flebo201812041306

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Abstract:

Aim — the objective of the present study was to generalize and systematize the available information published in the open sources about the application of different groups of medications for the pharmacological prevention of venous thromboembolism (VTE) after major orthopaedic surgery in the clinical practice. Material and methods. We undertook the search for the articles of interest in the PubMed (MEDLINE) and eLibrary literature databases with the use of the relevant key words. Each query consisted of the name of the pharmacological product or the generic name of the pharmacological agents and the words describing different variants of their application in the orthopaedic practice. Results. The review covers the publications containing the description of the results of the application of different groups of medications for the pharmacological prevention of thromboembolism after major orthopaedic surgery in the clinical practice. The reports on different phases of pre-authorization clinical studies were not included in the present analysis. Conclusion. The extensive application of the direct oral anticoagulants included in the majority of the clinical recommendations for the use in the routine clinical practice has demonstrated the high therapeutic effectiveness of dabigatran etexilate and rivaroxaban for the reduction of the frequency of development of venous thromboembolism. However, certain studies have revealed the increased risk of complications of the postoperative wounds. The scientific literature proved to contain no data on the use of apixaban in the real clinical practice following the major orthopaedic interventions. The results of the application of acetylsalicylic acid-based medications in the orthopaedic practice give evidence of the necessity to develop the more explicit criteria for their prescription.

Keywords:

venous thromboembolism

prevention

arthroplasty

dabigatran etexilate

rivaroxaban

apixaban

acetylsalicylic acid

monitoring

Authors:

Kasimova A.R.

R.R. Verden Russian Research Institute of Traumatology and Orthopaedics, Ministry of Health of the Russia, Sankt-Petersburg, Russia;
Academician I.P. Pavlov First Sankt-Petersburg State Medical University, Ministry of Health of the Russia, Sankt-Petersburg, Russia

Bozhkova S.A.

FGBU "Rossiĭskiĭ nauchno-issledovatel'skiĭ institut travmatologii i ortopedii im. R.R. Vredena" Minzdravsotsrazvitiia RF, Sankt-Peterburg

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References:

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