New therapeutic options in DVT prophylaxis
Review published in Orthopedics (2000)
Abstract
In the absence of prophylaxis, elective orthopedic surgery is associated with a high risk of venous thromboembolic events that are responsible for substantial morbidity and mortality. Despite the publication of articles questioning the significance of fatal pulmonary embolism (PE) following elective hip replacement, recent reports support the need for effective thromboprophylaxis in this indication. These reports also provide evidence of a significant reduction in fatal PE and overall mortality provided by treatment with low-molecular-weight heparin (LMWH), compared with unfractionated heparin. Even with the most effective prophylaxis currently available, however, deep vein thrombosis still develops in a minority of high-risk patients, indicating a need for improved therapies. Desirudin, a novel recombinant hirudin and direct thrombin inhibitor, has been shown to provide more effective prophylaxis than the most widely used LMWH, enoxaparin, in orthopedic surgery patients with multiple thromboembolic risk factors. This benefit was not associated with any increase in bleeding. Regional anesthesia and use of graduated compression stockings may provide additional independent reductions in thromboembolic risk in elective orthopedic surgery.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Desirudin, a recombinant hirudin and direct thrombin inhibitor, provides more effective prophylaxis than enoxaparin in orthopedic surgery patients with multiple thromboembolic risk factors.
Why This Matters for Hirudotherapy
This article examines prophylaxis against venous thromboembolism in elective orthopedic surgery, discussing anticoagulant options including LMWH and desirudin, described in the abstract as 'a novel recombinant hirudin and direct thrombin inhibitor.' The abstract reports that desirudin provided more effective prophylaxis than enoxaparin in orthopedic surgery patients with multiple thromboembolic risk factors, without increased bleeding. The article's relevance to ASH's domain is limited: although the abstract identifies desirudin as a recombinant hirudin, it makes no mention of leeches, the leech secretome, or hirudotherapy. The connection is indirect, as the discussion concerns a pharmaceutical anticoagulant in a surgical context.
Citation
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