Vol 8, No 4 (2006)
Published online: 2007-01-19
Secondary prophylaxis of deep venous thromboembolism. When is the application of low-molecular-weight heparins advisable? Review of the literature
Chirurgia Polska 2006;8(4):275-284.
Abstract
Deep vein thrombosis of the lower limbs is a frequent therapeutic problem, and additionally makes hemodynamic
functioning of the venous system worse for a long time. Treatment and primary prophylaxis
does not arouse controversies today. The secondary prevention of the deep vein thombosis lets one
effectively counteract post-thrombotic syndrome. Low molecular weight heparins have nearly completely
substituted nowadays unfracted heparins in primary prophylaxis. In secondary prophylaxis it is generally
accepted to administer oral anticoagulants, but there are numerous contraindications for administered
oral anticoagulants. Also many side effects are caused by these medicines. In this paper, the authors
wanted to answer the following question: in which patients does the administration of LMWH in
secondary prophylaxis bring benefits? They analysed over 50 articles and found some conclusions. There
are many advantages for pregnant patients and those suffering from a cancer who should be treated with
low-molecular-weight heparins. Many authors have noticed that LMWH and oral anticoagulants have
a similar efficacy and a comparable amount of serious haemorrhagic complications. Except for the groups
of patients who need long-term prophylaxis, the physician together with the patient should decide on
what method of treatment to choose.
Keywords: deep vein thrombosissecondary prophylaxisoral anticoagulantslow molecular weight heparin