Effectiveness of Different Low Molecular Weight Heparins in Patients with Deep Venous Thrombosis

Igor A. Suchkov ¹, Roman E. Kalinin ¹, Nina D. Mzhavanadze ¹, Aleksandr S. Pshennikov ¹, Andrey B. Agapov ¹, Aleksandr A. Tsaregorodtsev ²

¹ Ryazan State Medical University, Ryazan, Russia; ² Ryazan Regional Clinical Cardiologic Dispensary, Ryazan, Russia;

Date, time and location: 2018.05.26 13:30, Exhibition area, 1st Floor. Zone – B

Abstract

Objective:to assess the results of treatment with different low molecular weight heparins in patients with deep venous thrombosis (DVT).

Materials: the study included 45 patients with free-floating thrombus divided into two groups: 1 – 22 patients who received parnaparin (Fluxum®) 0.6ml SC BID, 2 – 23 patients treated with enoxaparin 1mg/kg SC BID. Duplex ultrasonography was used to evaluate effectiveness of treatment.

Results: median age of patients treated with parnaparin was 60.2±14.3 years. Localization of thrombus was common femoral vein (CFV) in 9 (41%), femoral vein (FV) in 6 (27%), common iliac vein (CIV) in 5 (23%), and popliteal vein (PV) in 2 patients (9%). At 8 to 10 days decrease of free-floating thrombus length was detected in 18 patients (64%) with total lysis in 4 patients (18%). In 4 patients (18%) the length of free-floating part of thrombus exceeded 30mm with slow tendency to lysis, which required a switch to enoxaparin with total lysis by 22 to 23 days. Such response to parnaparin therapy was linked to longer duration of DVT (more than 15 days) and obesity (body mass index 30.8±3.24).

Median age of patients treated with enoxaparin was 65.04±7.9 years. Localization of thrombus was CFV in 12 (52%), FV in 4 (17%), CIV in 3 (13%), external iliac vein in 2 (9%), and PV in 2 patients (9%). Median length of free-floating part of thrombus at baseline was 31.6±6.9mm. Enoxaparin was effective during all period of treatment with total lysis of free-floating part in all subjects by 13 to 15 days.

Median length of hospital stay was 10.7±5.5 days in group 1, and 9.8±2.5 days in group 2.

Conclusion.Parnaparin(Fluxum®) is non-inferior to enoxaparin in treatment of deep venous thrombosis in patients with disease duration less than 15 days and no obesity.