Prophylaxis by low molecular weight heparin against early thrombosis following infrainguinal arterial bypasses

Abstract EN

Purpose: To evaluate the perioperative prophylaxis by low molecular weight heparin (enoxaparine) on early graft patency after infrainguinal arterial bypass surgery.

Methods: The study was done at El hussein university hospital during a Zyar period from August 31, 1999 to July 31,2001.؛.

The 30 patients with critical chronic lower limb ischaemia who scheduled to undergo bypass surgery from the groin to a distal site were divided into two groups: Group (A): included 15 patients who received low molecular weight heparin (enoxaparine) at a dose of 40 mg subcutaneously (S.c.

every evening on the day before surgery and the same dose was repeated s.c.

every evening for 7 days.

And group (B): which is the control group and included 15 patients who did not received the drug.

Patients in both groups were evaluated for graft patency at the first post-operative day, one week and one monthat and after 3 months following bypass surgery.

Results: A total of 30 infrainguinal arterial reconstructive surgery performed, 17 were femoro-popliteal bypass above the knee joint, 9 femoro-popliteal below the knee and 4-femorotibial bypasses.

22 of these bypass procedures were performed by using prosthetic grafts and 8 were performed by using autogenous vein grafts.

In group A, the patency rate at the first post-operative day, one week, one month and after 3 months following surgery was 93.3%, 86.7%, 80% and 73ز% respectively.

While the patency rate in group B (control group) was 86!7%, '73.3%, 66.7% and 46.4% respectively.

The perioperative complications in gu^(A), were bleeding (13.3%).

myocardial infarction (6.7%ا) and death (6.7%).

While in group (B), these complications included myocardial infarction (6.7%) and death (6.7%).

Conclusions: Low molecular weight heparin is effective (١٨ 90 days femorodistal graft patency, but re-evaluation of its efficacy for longer duration .should he carried out.