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.
Resumen
Desirudin, a recombinant hirudin and direct thrombin inhibitor, provides more effective prophylaxis than enoxaparin in orthopedic surgery patients with multiple thromboembolic risk factors.
Por qué esto importa para la hirudoterapia
Este artículo examina la profilaxis contra el tromboembolismo venoso en cirugía ortopédica electiva, analizando opciones anticoagulantes, incluidas la HBPM y la desirudina, descrita en el resumen como 'una hirudina recombinante novedosa e inhibidor directo de la trombina'. El resumen informa que la desirudina proporcionó una profilaxis más eficaz que la enoxaparina en pacientes de cirugía ortopédica con múltiples factores de riesgo tromboembólico, sin aumento del sangrado. La relevancia del artículo para el ámbito de ASH es limitada: aunque el resumen identifica la desirudina como una hirudina recombinante, no menciona las sanguijuelas, el secretoma de la sanguijuela ni la hirudoterapia. La conexión es indirecta, ya que la discusión se refiere a un anticoagulante farmacéutico en un contexto quirúrgico.
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026