PMID- 8564488
OWN - NLM
STAT- MEDLINE
DCOM- 19960306
LR  - 20190920
IS  - 1078-5884 (Print)
IS  - 1078-5884 (Linking)
VI  - 11
IP  - 1
DP  - 1996 Jan
TI  - Low molecular mass heparin instead of unfractionated heparin during infrainguinal 
      bypass surgery.
PG  - 59-64
AB  - OBJECTIVES: To test whether low molecular mass heparin (LMMH) is comparable to 
      unfractionated heparin (UFH) as an anticoagulant during infrainguinal bypass 
      surgery and to investigate laboratory evidence of hypercoagulation in patients 
      undergoing infrainguinal bypass surgery. MATERIALS AND METHODS: Eighteen patients 
      were randomised to receive either UFH or LMMH (70 anti-Xa units/kg b.w.). Soluble 
      fibrin, measured as fibrin monomers (FM) and fibrinopeptide A (FPA), were 
      measured in blood from the femoral vein before, during and after release of the 
      occluding clamps during surgery. In addition, fibrinogen prothrombin complex, 
      thrombin-antithrombin complex, platelets and antithrombin were measured before 
      surgery. Heparin levels (Anti Xa) were measured during surgery. RESULTS: 
      Increased levels of fibrinogen, FPA, thrombin antithrombin complex and FM were 
      recorded prior to surgery. During surgery no further increase was noted. The anti 
      Xa levels were slightly higher in patients with LMMH than in patients receiving 
      UFH. Levels of FM were significantly lower in patients receiving LMMH. No 
      difference in FPA was noted. A positive correlation between fibrinogen and FPA 
      and FM respectively was recorded. Four patients, two in each group, were 
      reoperated for graft occlusion. One patient in the UFH group required reoperation 
      because of bleeding. CONCLUSIONS: LMMH is comparable to UFH as an anticoagulant 
      during infrainguinal bypass surgery. Variables reflecting hypercoagulability are 
      elevated in this group of patients and are positively correlated to the 
      fibrinogen level. High fibrinogen levels could thus be a risk for perioperative 
      thrombosis.
FAU - Swedenborg, J
AU  - Swedenborg J
AD  - Department of Surgery, Karolinska Hospital, Stockholm, Sweden.
FAU - Nydahl, S
AU  - Nydahl S
FAU - Egberg, N
AU  - Egberg N
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Eur J Vasc Endovasc Surg
JT  - European journal of vascular and endovascular surgery : the official journal of 
      the European Society for Vascular Surgery
JID - 9512728
RN  - 0 (Anticoagulants)
RN  - 0 (Fibrin Fibrinogen Degradation Products)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 0 (antithrombin III-protease complex)
RN  - 0 (fibrinmonomer)
RN  - 25422-31-5 (Fibrinopeptide A)
RN  - 9000-94-6 (Antithrombin III)
RN  - 9005-49-6 (Heparin)
RN  - EC 3.4.- (Peptide Hydrolases)
RN  - EC 3.4.21.6 (Factor Xa)
SB  - IM
MH  - Aged
MH  - Anticoagulants/*therapeutic use
MH  - Antithrombin III/analysis
MH  - Factor Xa/analysis
MH  - Female
MH  - Fibrin Fibrinogen Degradation Products/analysis
MH  - Fibrinopeptide A/analysis
MH  - Hematocrit
MH  - Heparin/blood/therapeutic use
MH  - Heparin, Low-Molecular-Weight/*therapeutic use
MH  - Humans
MH  - Leg/*blood supply
MH  - Male
MH  - Peptide Hydrolases/analysis
MH  - Platelet Count
MH  - *Vascular Surgical Procedures
EDAT- 1996/01/01 00:00
MHDA- 1996/01/01 00:01
CRDT- 1996/01/01 00:00
PHST- 1996/01/01 00:00 [pubmed]
PHST- 1996/01/01 00:01 [medline]
PHST- 1996/01/01 00:00 [entrez]
AID - S1078-5884(96)80135-3 [pii]
AID - 10.1016/s1078-5884(96)80135-3 [doi]
PST - ppublish
SO  - Eur J Vasc Endovasc Surg. 1996 Jan;11(1):59-64. doi: 
      10.1016/s1078-5884(96)80135-3.