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AB0342 Prevention of venous thromboembolic complications in total hip and total knee arthroplasty for patients with rheumatic diseases
  1. A. Rybnikov1,
  2. E. Byalik1,
  3. S. Makarov1,
  4. V. Pavlov1,
  5. T. Reshetnyak1,
  6. M. Semenova1,
  7. D. Ivanov1
  1. 1FSBI «Research Institute of Rheumatology» under the RAMs, Moscow, Russian Federation

Abstract

Background Deep venous thrombosis of the lower limbs occur in 42-65% of the total knee and total hip arthroplasty.

Objectives To evaluate the efficiency of oral anticoagulants in the post operational period for patients with rheumatic diseases.

Methods We have analyzed 146 patients with rheumatic diseases affections of the knees and hips who were operated in the Department of Traumatology and Orthopaedics of the State Institute Of Rheumatology Of Russian Academy Of Medical Sciences in 2012. We have performed thromboembolic compications of 48 patients with oral anticoagulants – a direct thrombin inhibitor - Dabigatran etexilate. We have used a Xa inhibitor factor on 98 patients – a rivaroxaban. The first intake of dabigatran etexilate (110mg) or rivaroxaban (10mg) was performed on the first day after the surgery. Later the patients were taking 220 mg (2 capsules) of dabigatran etexilate once per day or 10 mg of rivaroxaban once per day for 28-35 days. We were taking the control on the efficiency of thromboembolic complications with the help of ultrasound triplex angioscanning. The first ultrasound scanning was taken on the 3 day after the surgery and then on a weekly basis.

Results Venous thromboses of the lower limbs were not found in 45 cases (93.8% of the patients) who were taking dabigatran etexilate during weekly ultrasound scanning. Early unjustified cancellation of dabigatran etexilate after 15 days after the total hip replacement (outpatient) in case of three patients (6.2%) led to the floating ileofemoral thrombosis. One patient (1.02%) who was taking rivaroxaban had occlusive thrombosis of the femoral vein on the contralateral side. Reason: late intake (start after 3 days) of the prescribed medicine. Bleedings were not noted in postoperative period.

Conclusions Dabigatran etexilate and rivaroxaban were effective and convenient medicines for the thromboembolic complications prevention for patients in rheumatic diseases in the postoperative period.

Disclosure of Interest None Declared

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