BENEFIT OF HYPOCOAGULATION AFTER LOWER LIMB BYPASS - A SYSTEMATIC REVIEW
Introduction: After surgical revascularization of the lower limb, antiplatelet agents are usually prescribed and anticoagulation is considered in cases of high risk of thrombosis. We conducted a systematic literature review of the existing evidence on long term prescription of anticoagulants in the postoperative.
Material and methods: Systematic review of the literature available in the Pubmed database.
Results: The studies selected for the final review consisted of: 6 randomized controlled trials (and 4 post-hoc analyzes), 1 prospective study with historical controls and 3 retrospective studies.
Conclusion: The efficacy of hypocoagulation depends on the conduit used and its intrinsic factors. There is benefit of hypocoagulation in the autologous venous lower limb bypasses, but the INR range and risk factors for thrombosis may influence the results. In the non-venous grafts there may be benefit in those with reduced caliber and low average flow. The incidence of major bleeding is significant, and a careful evaluation of the risk-benefit ratio in the prescription of chronic hypocoagulation is essential.
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