European journal of medical research
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Pulmonary embolism is a frequently observed clinical symptom. Its mortality rate is ca. 10 % und occurs mainly in the acute phasis. Immobilization, surgery, old age, malignancies, hormonal factors as well as inherited or acquired thrombophilia are important risk factors. ⋯ The risk of pulmonary embolism could be lowered by 50 % through prophylaxis with unfractioned or low-molecular-weight heparin. The therapy of pulmonary embolism stratifies the clinical grade and reaches from ambulant therapy with low-molecular-weight heparin to thrombolysis or embolectomy in massive pulmonary embolism. Long-term anticoagulation, usually with vitamin-K-antagonists, should be applied according to the individual risk profile of the patient.
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Review Comparative Study
Low-molecular-weight heparin (LMWH) in the treatment of thrombosis.
Thromboembolic complications are a common and costly medical problem, associated with significant morbidity and mortality, especially in postoperative patients. There have been reports of death due to thromboembolic complications even after short procedures, e.g. arthroscopy. Low-molecular-weight heparins (LMWHs) (e.g., certoparin, dalteparin, enoxaparin, nadroparin, reviparin, tinzaparin) have been tested for treatment of deep vein thrombosis in comparison to unfractionated heparin (UFH) in many patients being effective and safe alternative for treatment of deep vein thrombosis (DVT) and venous thromboembolism (VTE). ⋯ In summary, LMWHs have an established role in the treatment of DVT and pulmonary embolism (PE), on an in- and outpatient basis and could realize substantial savings. Most studies were performed with dalteparin, enoxaparin and nadroparin. There is evidence that LMWHs may help to prolong survival in cancer patients and to avoid complications of the acute coronary syndrome.