EFFICIENCY OF THE LOW MOLECULAR WEIGHT HEPARIN IN TREATMENT OF DEEP VEIN THROMBOSIS

Methods: Sixty-eight patients with symptoms of deep vein thrombosis and diagnosed with doppler USG who underwent anticoagulation with either subcutaneous fixed dose low molecular weight heparin (Group 1, n=40) or standart unfractionated heparin infusion (Group 2, n=28) were investigated retrospectively. Oral anticoagulation with coumadin was started following admitting to hospital and continued for 12 weeks. Patients were followed for one year with regard to physical and doppler ultrasonographic findings.

Results: Patients who received standart heparin experienced major bleeding complications more frequently during hospital stay (p=0.03). Two patients in both groups had recurrent deep vein thrombosis during follow up period (p>0.05). In long term, 2 patients in group 1 and 1 patient in group 2 had oral anticoagulant related bleeding (p>0.05). Although there was no hospital mortality, during 1 year follow up period, 3 patients in group 1 and 2 patients in group 2 died. Although no differences between groups was observed, long term doppler ultrasonographic findings revealed effects of INR levels over recanalization rate.

Conclusion: For the initial treatment of deep vein thrombosis, fixed dose, subcutaneous low molecular weight heparin usage is equally effective with intravenous standart heparin infusion. Incidence of major bleeding with low molecular heparin usage is lower than standart heparin infusion. In long term, adequacy of anticoagulation is crucial for the prevention of deep vein thrombosis related complications. (Turkish J Vasc Surg 2003;12(3): 15-20)