PMID- 15946209
OWN - NLM
STAT- MEDLINE
DCOM- 20050922
LR  - 20230829
IS  - 1538-7933 (Print)
IS  - 1538-7836 (Linking)
VI  - 3
IP  - 6
DP  - 2005 Jun
TI  - Prevention of venous thromboembolism after acute ischemic stroke.
PG  - 1187-94
AB  - Venous thromboembolism (VTE) is a common complication after acute ischemic 
      stroke. When screened by 125I fibrinogen scanning or venography, the incidence of 
      deep-vein thrombosis (DVT) in stroke patients is comparable with that seen in 
      patients undergoing hip or knee replacement. Most stroke patients have multiple 
      risk factors for VTE, like advanced age, low Barthel Index severity score or 
      hemiplegia. As pulmonary embolism is a major cause of death after acute stroke, 
      the prevention of this complication is of crucial importance. Prospective trials 
      have shown that both unfractionated heparin (UFH) and low molecular weight 
      heparin (LMWH) are effective in reducing DVT and pulmonary embolism in stroke 
      patients. Current guidelines recommend the use of these agents in stroke patients 
      with risk factors for VTE. Some clinicians are concerned that the rate of 
      intracranial bleeding associated with thromboprophylaxis may outweigh the benefit 
      of prevention of VTE. Low-dose LMWH and UFH seem, however, safe in stroke 
      patients. Higher doses clearly increase the risk of cerebral bleeding and should 
      be avoided for prophylactic use. Both aspirin and mechanical prophylaxis are 
      suboptimal to prevent VTE. Graduated compression stockings should be reserved to 
      patients with a clear contraindication to antithrombotic agents.
FAU - Kamphuisen, P W
AU  - Kamphuisen PW
AD  - Stroke Unit and Division of Internal and Cardiovascular Medicine, University of 
      Perugia, Perugia, Italy.
FAU - Agnelli, G
AU  - Agnelli G
FAU - Sebastianelli, M
AU  - Sebastianelli M
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - England
TA  - J Thromb Haemost
JT  - Journal of thrombosis and haemostasis : JTH
JID - 101170508
RN  - 0 (Anticoagulants)
RN  - 0 (Hematologic Agents)
SB  - IM
MH  - Aged
MH  - Anticoagulants/administration & dosage/therapeutic use
MH  - Brain Ischemia
MH  - Female
MH  - Hematologic Agents/administration & dosage/therapeutic use
MH  - Humans
MH  - Premedication
MH  - Stroke/*complications
MH  - Thromboembolism/drug therapy/*prevention & control
MH  - Venous Thrombosis/drug therapy/*prevention & control
RF  - 45
EDAT- 2005/06/11 09:00
MHDA- 2005/09/24 09:00
CRDT- 2005/06/11 09:00
PHST- 2005/06/11 09:00 [pubmed]
PHST- 2005/09/24 09:00 [medline]
PHST- 2005/06/11 09:00 [entrez]
AID - S1538-7836(22)16065-4 [pii]
AID - 10.1111/j.1538-7836.2005.01443.x [doi]
PST - ppublish
SO  - J Thromb Haemost. 2005 Jun;3(6):1187-94. doi: 10.1111/j.1538-7836.2005.01443.x.