This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Paramo, J. C. Articles by Sivina, M. Search for Related Content PubMed PubMed Citation Articles by Paramo, J. C. Articles by Sivina, M. Social Bookmarking                         What's this?

Comparison of the Use of Enoxaparin Versus Unfractionated Heparin in Patients Undergoing Lower Extremity Revascularization

Harry Sendzischew, MD, FACS

Manuel Sivina, MD, FACS

Department of Surgery, Mount Sinai Medical Center, Miami Beach, FL

Present available studies suggest that heparin prevents early vessel thrombosis in the immediate postoperative (POP) period after lower extremity bypass. Long-term anticoagulation with warfarin has also been used in these patients, based on its beneficial effect in preventing long-term graft failure. To compare the effectiveness between unfractionated heparin (UH) and low-molecular-weight heparin (enoxaparin) when used as transitional therapeutic POP anticoagulant therapy, a prospective study was performed. Seventy consecutive patients undergoing lower extremity bypass were studied. The initial 35 patients were started on a drip of UH 6 hours POP. The next 35 consecutive patients were treated with enoxaparin, the first dose starting 6 hours POP. All patients underwent subsequent anticoagulation with oral warfarin. There were no statistically significant differences between the two groups with regard to demographics, percentage of above/below the knee bypasses, type of conduit used, emergency operations, and overall complications. There was a significant difference in the length of stay (p = 0.05) in favor of the enoxaparin group, which also reflected a decreased overall cost in this group. In conclusion, POP anticoagulation with enoxaparin is as safe end effective as UH in patients undergoing lower extremity revascularization. Enoxaparin was associated with a decreased overall length of stay and hospital costs.

Vascular and Endovascular Surgery, Vol. 36, No. 3, 199-205 (2002)
DOI: 10.1177/153857440203600307


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?