Document Detail

Acute lower limb ischemia: failure of anticoagulant treatment to improve one-month results of arterial thromboembolectomy. A prospective randomized multi-center study.
MedLine Citation:
PMID:  2020905     Owner:  NLM     Status:  MEDLINE    
The value of short-term anticoagulant treatment in improving the early outcome in patients operated on for acute lower-limb ischemia has been debated and so far unproven. In this prospective randomized multi-center study, 188 such patients were randomized on admission, either to preoperative and postoperative anticoagulant medication (AC group, n = 94) or no anticoagulant treatment during the first month after surgery (O group, n = 94). Background factors were evenly distributed in the two groups, and 89% of the cases were considered as embolic. Analysis on an intention-to-treat basis showed no differences in outcome after 30 days. Good results, survivors who had amputation, and patients who died in the two groups are given respectively: AC group, 61%, 9%, 30%; O group, 65%, 11%, 24%. The results were similar in the two treatment groups also if only patients with a cardiac source of embolism were analyzed. Local bleeding complications were more common in the AC group (17% vs 2%, p less than 0.01). It is concluded that preoperative and early postoperative anticoagulant medication should not be routinely administered since such treatment is unlikely to improve the short-term results of lower-limb arterial thromboembolectomy while bleeding complications increase. The possible value of late (beyond 1 month) long-term anticoagulant treatment remains to be studied.
L Jivegård; J Holm; D Bergqvist; C G Björck; H Björkman; U Brunius; G Claes; J Hammarsten; B Jernby; P Konrad
Related Documents :
16859935 - Early experience with the retrievable optease vena cava filter in high-risk trauma pati...
19847375 - Does prolonged warfarin exposure potentiate coronary calcification in humans? results o...
9576405 - Anticardiolipin antibodies predict early recurrence of thromboembolism and death among ...
23553475 - Systematic review and meta-analysis of standard vs selective temporal lobe epilepsy sur...
19197095 - Day surgery varicose vein treatment using endovenous laser.
19952015 - Mid-term evaluation of sorin soprano bioprostheses in patients with a small aortic annu...
Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Surgery     Volume:  109     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  1991 May 
Date Detail:
Created Date:  1991-05-29     Completed Date:  1991-05-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  610-6     Citation Subset:  AIM; IM    
Department of Surgery, Sahlgrenska Hospital, Göteborg, Sweden.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Anticoagulants / adverse effects,  therapeutic use*
Arterial Occlusive Diseases / drug therapy*,  surgery
Gangrene / etiology
Hemorrhage / chemically induced
Ischemia / drug therapy*,  surgery
Leg / blood supply*,  surgery
Prospective Studies
Thromboembolism / drug therapy*,  surgery
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Somatosensory-evoked potentials during carotid artery surgery: experience in 400 operations.
Next Document:  Complete external iliac artery disruption after percutaneous aortic valvuloplasty in two young child...