PMID- 20847691
OWN - NLM
STAT- MEDLINE
DCOM- 20110223
LR  - 20181201
IS  - 1473-6500 (Electronic)
IS  - 0952-7907 (Linking)
VI  - 23
IP  - 6
DP  - 2010 Dec
TI  - The new oral anticoagulants, do they change the benefit vs. risk for 
      thromboprophylaxis in association to ambulatory surgery?
PG  - 722-5
LID - 10.1097/ACO.0b013e32833f9ea6 [doi]
AB  - PURPOSE OF REVIEW: Several randomized controlled trials have shown that 
      pharmacological thromboprophylaxis with low-dose unfractionated heparin (UFH), 
      low molecular weight heparin (LMWH) or fondaparinux reduces venous 
      thromboembolism (VTE) after general surgery. No high-quality evidence supports 
      the use of pharmacological thromboprohylaxis with traditional antithrombotic 
      drugs in patients undergoing ambulatory surgery without additional VTE risk 
      factors, stratified at low risk of VTE by the American College of Chest 
      Physicians guidelines. Two new drug classes, the direct thrombin and factor Xa 
      (FXa) inhibitors, have been developed with a potentially better risk-benefit 
      profile. RECENT FINDINGS: Oral administration, predictable anticoagulant 
      responses, low potential for drug-drug interactions render direct thrombin and 
      factor Xa inhibitors good candidates to replace UFH, LMWH and fondaparinux for 
      VTE prophylaxis. Most of all, the positive results of the first published 
      clinical trials in orthopedic thromboprophylaxis allowed dabigatran etexilate and 
      rivaroxaban to be licensed in Canada and in European Union for the prevention of 
      VTE in patients undergoing hip-replacement and knee-replacement surgery. SUMMARY: 
      No randomized trials with the new anticoagulants are ongoing in ambulatory 
      surgery. However, currently available drugs--that is UFH, LMWH or 
      fondaparinux--are administered subcutaneously and the new anticoagulants would 
      offer the clear advantage of an oral administration, without request for blood 
      testing to monitor potential adverse effects such as heparin-induced 
      thrombocytopenia, thus potentially simplifying the treatment out of the hospital.
FAU - Squizzato, Alessandro
AU  - Squizzato A
AD  - Research Center on Thromboembolic Disorders and on Antithrombotic Therapies, 
      Department of Clinical Medicine, University of Insubria, Varese, Italy. 
      alexsquizzo@libero.it
FAU - Romualdi, Erica
AU  - Romualdi E
FAU - Dentali, Francesco
AU  - Dentali F
FAU - Ageno, Walter
AU  - Ageno W
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Curr Opin Anaesthesiol
JT  - Current opinion in anaesthesiology
JID - 8813436
RN  - 0 (Anticoagulants)
RN  - 0 (Factor Xa Inhibitors)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 0 (Polysaccharides)
RN  - 9005-49-6 (Heparin)
RN  - EC 3.4.21.5 (Thrombin)
RN  - J177FOW5JL (Fondaparinux)
SB  - IM
MH  - Administration, Oral
MH  - *Ambulatory Surgical Procedures
MH  - Anticoagulants/*therapeutic use
MH  - Factor Xa Inhibitors
MH  - Fondaparinux
MH  - Heparin/therapeutic use
MH  - Heparin, Low-Molecular-Weight/therapeutic use
MH  - Humans
MH  - Polysaccharides/therapeutic use
MH  - Premedication/*methods
MH  - Randomized Controlled Trials as Topic
MH  - Risk Assessment
MH  - Thrombin/antagonists & inhibitors
MH  - Venous Thromboembolism/*prevention & control
EDAT- 2010/09/18 06:00
MHDA- 2011/02/24 06:00
CRDT- 2010/09/18 06:00
PHST- 2010/09/18 06:00 [entrez]
PHST- 2010/09/18 06:00 [pubmed]
PHST- 2011/02/24 06:00 [medline]
AID - 10.1097/ACO.0b013e32833f9ea6 [doi]
PST - ppublish
SO  - Curr Opin Anaesthesiol. 2010 Dec;23(6):722-5. doi: 10.1097/ACO.0b013e32833f9ea6.