Safety and Efficacy of Novel Oral Anticoagulants vs Low Molecular Weight Heparin for Thromboprophylaxis in Large-Volume Liposuction and Body Contouring Procedures
| Autor: | Paul Fortes, Henry Mentz, Rolando Morales, German Newall, Amelia E. Bush, Christopher Patronella, Kristi L. Hustak, Eric Ruff |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_treatment Deep vein Blood Loss Surgical Administration Oral 030230 surgery 0302 clinical medicine Rivaroxaban Risk Factors Hematoma Venous Thromboembolism General Medicine Middle Aged Texas Pulmonary embolism Treatment Outcome medicine.anatomical_structure 030220 oncology & carcinogenesis Female Apixaban medicine.drug Adult medicine.medical_specialty Adolescent Acute blood loss anemia Pyridones medicine.drug_class Low molecular weight heparin Postoperative Hemorrhage Young Adult 03 medical and health sciences Lipectomy medicine Humans Blood Transfusion Aged Retrospective Studies business.industry Anticoagulants Heparin Low-Molecular-Weight medicine.disease medicine.icd_9_cm_classification Surgery Liposuction Body contouring Pyrazoles business Factor Xa Inhibitors |
| Zdroj: | Aesthetic Surgery Journal. 36:440-449 |
| ISSN: | 1527-330X 1090-820X |
| Popis: | Background Preventing venous thromboembolism (VTE) remains an important topic in the plastic surgery community. However, there is little consensus regarding appropriate VTE prophylaxis for patients undergoing common body contouring procedures. Objectives This study compared the use of two novel oral anticoagulants (Rivaroxaban and Apixiban) vs low molecular weight heparin (LMWH) for postoperative chemical prophylaxis in body contouring plastic surgery procedures. Methods A single center retrospective chart review of 1572 patients who underwent body contouring plastic surgery procedures from January 2012 to February 2015 was performed. Major complications associated with chemical prophylaxis were reviewed including hematomas requiring surgical evacuation, acute blood loss anemia requiring transfusions, and thrombotic or hemorrhagic events. Results Drug-related adverse events occurred in 1.27% (n = 20) of patients. The complications encountered by the 454 patients on LMWH consisted of 0.88% (n = 4) with hematomas requiring surgical evacuation, 0.44% (n = 2) with decreased hemoglobin requiring transfusions, and 0.22% (n = 1) with a deep vein thrombosis (DVT). The complications encountered by 703 patients on with Rivaroxaban consisted of 1.3% (n = 9) with hematomas requiring surgical evacuation, 0.43% (n = 3) with decreased hemoglobin requiring transfusions, and 0.1% (n = 1) with a DVT and pulmonary embolism. The complications encountered by 415 patients on with Apixaban consisted of 0.48% (n = 2) with a DVT. Conclusions Novel oral anticoagulants (Rivaroxaban and Apixiban) are comparable to LMWH for chemical prophylaxis after body contouring procedures with similar rates of drug-related complications. Further investigation is warranted with more clinical cases in order to recommend the use of this medication for routine postoperative chemical prophylaxis after body contouring procedures. Level of Evidence 3![Graphic][1] Therapeutic [1]: /embed/inline-graphic-1.gif |
| Databáze: | OpenAIRE |
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