Heparin prophylaxis no help after knee arthroscopy or leg casting (POT-KAST, POT-CAST)
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Low molecular weight heparin (LMWH) at preventive doses after arthroscopic knee surgery or leg casting did not prevent venous thromboembolism (DVT or PE), in two Dutch randomized trials. The study helps fill a large gap in knowledge regarding risks and benefits of prophylactic anticoagulation in patients undergoing these procedures. In one (POT-KAST), 1,543 patients received either nadroparin (Fraxiparine) or dalteparin (Fragmin) -- both LMWH -- once daily for 8 days after knee surgery or no anticoagulant (non-blinded, no placebo). Symptomatic venous thromboembolism (DVT or PE) occurred in 0.7% of the heparin group, and 0.4% rate among the controls. Major bleeding occurred in 0.1% of each group, with no deaths in 3 months of follow-up. In POT-CAST, the same investigators used the same LMWH products among 1,519 patients who were immobile due to lower leg casting. Patients were randomized to either prophylactic anticoagulation or none: 1.4% of patients receiving LMWH, and 1.8% of controls experienced DVT or PE, with no major bleeding. Authors concluded:
Heparin prophylaxis no help after knee arthroscopy or leg casting (POT-KAST, POT-CAST)
Heparin prophylaxis no help after knee…
Heparin prophylaxis no help after knee arthroscopy or leg casting (POT-KAST, POT-CAST)
Low molecular weight heparin (LMWH) at preventive doses after arthroscopic knee surgery or leg casting did not prevent venous thromboembolism (DVT or PE), in two Dutch randomized trials. The study helps fill a large gap in knowledge regarding risks and benefits of prophylactic anticoagulation in patients undergoing these procedures. In one (POT-KAST), 1,543 patients received either nadroparin (Fraxiparine) or dalteparin (Fragmin) -- both LMWH -- once daily for 8 days after knee surgery or no anticoagulant (non-blinded, no placebo). Symptomatic venous thromboembolism (DVT or PE) occurred in 0.7% of the heparin group, and 0.4% rate among the controls. Major bleeding occurred in 0.1% of each group, with no deaths in 3 months of follow-up. In POT-CAST, the same investigators used the same LMWH products among 1,519 patients who were immobile due to lower leg casting. Patients were randomized to either prophylactic anticoagulation or none: 1.4% of patients receiving LMWH, and 1.8% of controls experienced DVT or PE, with no major bleeding. Authors concluded: