Reviparin as prophylaxis for thromboembolism after leg injury and hip replacement

Venous thromboembolism is a common, life-threatening complication after leg injury or hip replacement surgery. Treatment with the low-molecular-weight heparin reviparin prevented deep-vein thrombosis during immobilisation of the leg for fracture or rupture of the Achilles tendon. Thus, using venography, deep-vein thrombosis was diagnosed in 17 (9%) of the 183 patients in the reviparin group, which was significantly less than the 35 (19%) of 188 patients in the placebo group. Bleeding events occurred in 14 patients in the reviparin group and 12 in the placebo group. In another study comparing reviparin with oral anticoagulants, reviparin and acenocoumarol were shown to be equally effective in preventing deep-vein thrombosis after hip surgery, but reviparin caused less bleeding. In this study, thromboembolic events were detected by overt symptoms followed by venography for deep-vein thrombosis or ventilation-perfusion scanning for pulmonary embolism. The incidence of a thromboembolic events in the reviparin (15 of 643 patients; 2.3%) and acenocoumarol groups (21 of 636 patients; 3.3%) was similar but major bleeding occurred in fewer patients with reviparin (n = 9, 1.4%) than acenocoumarol (n = 35, 5.5%). These studies show that reviparin is effective as prophylaxis for thromboembolism after leg injury and hip replacement, and does not cause an excess of bleeding.