Document Detail


Treatment of early symptomatic pulmonary embolism after total joint arthroplasty.
MedLine Citation:
PMID:  8872569     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The purpose of this study was to evaluate the risk of intravenous heparin therapy or the use of Greenfield filters (Meditech, Watertown, MA) in the early postoperative period in patients who have documented symptomatic pulmonary embolism. Symptomatic pulmonary embolism in the first weeks was identified in 52 patients. Twenty-four patients were treated with Greenfield filter insertion and 28 patients with intravenous heparin therapy. One complication associated with insertion of the Greenfield filter-premature opening in the internal jugular vein-resulted in no adverse consequences. Three complications were associated with intravenous heparin therapy: one transient thrombocytopenia, one recurrent symptomatic pulmonary embolism, and one knee hematoma, which did not require surgical evacuation. It appears that Greenfield filter insertion is a viable option for treatment of symptomatic pulmonary embolism in the early postoperative period after total joint arthroplasty. In contrast to other published data, this study suggests that intravenous heparin therapy may also be a reasonable alternative, but is a treatment regimen that requires careful monitoring of platelets, wound complications, and bleeding parameters.
Authors:
P S Bicalho; W J Hozack; R H Rothman; K Eng
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of arthroplasty     Volume:  11     ISSN:  0883-5403     ISO Abbreviation:  J Arthroplasty     Publication Date:  1996 Aug 
Date Detail:
Created Date:  1997-02-28     Completed Date:  1997-02-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8703515     Medline TA:  J Arthroplasty     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  522-4     Citation Subset:  IM    
Affiliation:
Rothman Institute, Jefferson Medical College, Philadelphia, PA 19107, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Female
Hematoma / chemically induced
Heparin / adverse effects,  therapeutic use*
Hip Prosthesis / adverse effects*
Humans
Infusions, Intravenous
Knee Prosthesis / adverse effects*
Male
Middle Aged
Postoperative Complications
Postoperative Period
Pulmonary Embolism / drug therapy,  etiology,  therapy*
Thrombocytopenia / chemically induced
Vena Cava Filters* / adverse effects
Chemical
Reg. No./Substance:
9005-49-6/Heparin

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


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