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    
Abstract/OtherAbstract:
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.
Authors:
L Jivegård; J Holm; D Bergqvist; C G Björck; H Björkman; U Brunius; G Claes; J Hammarsten; B Jernby; P Konrad
Related Documents :
20514955 - Rapid reversal of coagulopathy in warfarin-related intracranial haemorrhages with proth...
8512435 - Evaluation of a portable prothrombin time monitor for home use by patients who require ...
9869155 - A cost-effectiveness analysis of aspirin versus oral anticoagulants after acute myocard...
24556735 - Stopping antiepileptic drugs in seizure-free patients.
7833205 - Joint-preserving operations for elderly patients with advanced and late-stage coxarthri...
6235105 - Isotretinoin. a review of its pharmacological properties and therapeutic efficacy in ac...
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    
Affiliation:
Department of Surgery, Sahlgrenska Hospital, Göteborg, Sweden.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Amputation
Anticoagulants / adverse effects,  therapeutic use*
Arterial Occlusive Diseases / drug therapy*,  surgery
Gangrene / etiology
Hemorrhage / chemically induced
Humans
Ischemia / drug therapy*,  surgery
Leg / blood supply*,  surgery
Prospective Studies
Thromboembolism / drug therapy*,  surgery
Chemical
Reg. No./Substance:
0/Anticoagulants

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...