Two-Step Warfarin Therapy for the Prophylaxis of Venous Thrombosis After Elective Surgery
A recurrent theme in the management of patients subjected to major surgical procedures has been the need for safe but effective anti-thrombotic treatment. This is an especially difficult dilemma for extensive bone or joint repair or replacement surgery, during which the prothrombotic tendencies would appear to require the use of more intensive anticoagulant therapy. Thus, Sevitt and Gallagher demonstrated a clearcut decrease in clinical deep vein thrombosis and pulmonary embolism and in autopsy-proven thrombotic disease with coumarin therapy before repair of hip fracture, but this was achieved at an increased risk of bleeding complication (Table 1).
KeywordsDeep Vein Thrombosis International Normalize Ratio Prothrombin Time Recurrent Deep Vein Thrombosis Prothrombin Time Ratio
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