PMID- 18709991
OWN - NLM
STAT- MEDLINE
DCOM- 20080926
LR  - 20080819
IS  - 0047-1860 (Print)
IS  - 0047-1860 (Linking)
VI  - 56
IP  - 7
DP  - 2008 Jul
TI  - [Advancement of prophylaxis and therapy for venous thromboembolism].
PG  - 589-99
AB  - Recently in Japan, venous thromboembolism (VTE) [deep vein thrombosis 
      (DVT)/pulmonary thromboembolism (PTE)] has increased with the Westernization of 
      eating habits and aging of society. In the West, the prophylaxis guidelines have 
      been discussed for many years. Unfortunately, Japan falls far behind the West in 
      this area. Therefore, the necessity of thromboprophylaxis in Japanese people 
      should be emphasized based on reliable VTE studies in Japan. In orthopedic 
      surgery, prospective multicenter studies in Japan indicate that the incidence of 
      DVT/PTE in total hip or knee replacement surgery and hip fracture surgery were 
      almost equal to those in Western people. Furthermore, a multi-center, prospective 
      epidemiological study in Japan revealed that the incidence of VTE following major 
      abdominal surgery was 24.3%. We developed Japanese Guidelines for VTE prophylaxis 
      based on the 6th ACCP guideline in 2004. The incidence of perioperative PTE in 
      Japan has been investigated by the Japanese Society of Anesthesiologists since 
      2002. The rate of perioperative PTE was estimated to be 4.41 per 10,000 
      operations in 2002, and 4.76 in 2003; however, it decreased to 3.61 immediately 
      after the guideline for thromboprophylaxis was issued and the management fee for 
      PTE prophylaxis became covered by health insurance in April 2004. Furthermore, it 
      markedly decreased in 2005. However, mechanical prophylaxis is not sufficient to 
      prevent PTE, and advanced prophylaxis by anticoagulants, such as 
      low-molecular-weight heparin/selective Xa inhibitor along with unfractionated 
      heparin (UFH)/vitamin K antagonists (VKA) will be essential. The advanced revised 
      guidelines for VTE prophylaxis based on our clinical evidence will be established 
      in the near future. As for treatment for VTE, anticoagulant and thrombolytic 
      therapies are essential. In cases with VTE, UFH followed by VKA (INR: 1.5-2.5) is 
      standard. In cases of PTE with shock, thrombolytic therapy such as tissue 
      plasminogen activator or urokinase, catheter intervention, or surgical procedures 
      under pericutaneous cardiopulmonary support should be selected based on the 
      severity of PTE.
FAU - Kobayashi, Takao
AU  - Kobayashi T
LA  - jpn
PT  - English Abstract
PT  - Journal Article
PT  - Review
PL  - Japan
TA  - Rinsho Byori
JT  - Rinsho byori. The Japanese journal of clinical pathology
JID - 2984781R
RN  - 0 (Anticoagulants)
RN  - 0 (Fibrinolytic Agents)
SB  - IM
MH  - Anticoagulants/*administration & dosage
MH  - Fibrinolytic Agents/*administration & dosage
MH  - Humans
MH  - Japan
MH  - Orthopedic Procedures
MH  - Postoperative Complications
MH  - *Practice Guidelines as Topic
MH  - Pulmonary Embolism/epidemiology/etiology/physiopathology/prevention & control
MH  - Thrombolytic Therapy
MH  - Venous Thromboembolism/epidemiology/etiology/physiopathology/*prevention & 
      control
RF  - 26
EDAT- 2008/08/20 09:00
MHDA- 2008/09/27 09:00
CRDT- 2008/08/20 09:00
PHST- 2008/08/20 09:00 [pubmed]
PHST- 2008/09/27 09:00 [medline]
PHST- 2008/08/20 09:00 [entrez]
PST - ppublish
SO  - Rinsho Byori. 2008 Jul;56(7):589-99.