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Effects of a Foot Pump on the Incidence of Deep Vein Thrombosis After Total Knee Arthroplasty in Patients Given Edoxaban

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タイトル: Effects of a Foot Pump on the Incidence of Deep Vein Thrombosis After Total Knee Arthroplasty in Patients Given Edoxaban
その他のタイトル: ランダム化比較試験によるエドキサバン投与下におけるTKA後DVT発生に対するフットポンプの有効性
著者: 坂井, 達弥
著者(別表記) : Sakai, Tatsuya
発行日: 2017年 9月20日
出版者: Lippincott Williams and Wilkins
引用: Nagasaki University (長崎大学), 博士(医学) (2017-09-20)
抄録: We conducted a randomized clinical trial to compare the effectiveness of the A-V Impulse System foot pump for reducing the incidence of deep-vein thrombosis (DVT) after total knee arthroplasty (TKA) in patients under edoxaban thromboprophylaxis. Patients undergoing primary TKA at our institution between September 2013 and March 2015 were enrolled after obtaining informed consent. The patients were randomized to use the foot pump (n = 58) and not to use the foot pump (n = 62). Both groups were given prophylactic edoxaban. Primary outcomes were any DVT as detected by bilateral ultrasonography up to postoperative day 10 (POD10) and pulmonary embolism (PE) up to POD28. The safety outcomes were bleeding and death of any cause up to POD28. Plasma D-dimer levels were measured before TKA and on POD10 after TKA. Immunoglobulin G (IgG)-class anti-PF4/heparin antibodies were measured using an IgG-specific enzyme-linked immunosorbent assay. The incidences of any DVT up to POD28 were 31.0% and 17.7% in patients with or without the foot pump, respectively. The incidences of major bleeding up to POD28 were 5.1% and 4.8% in patients with or without the foot pump, respectively. Foot pump use did not significantly reduce the incidence of DVTs in patients undergoing TKA under edoxaban thromboprophylaxis. Although seroconversion of anti-PF4/heparin antibodies was confirmed in one-fourth of patients, the seroconversion rates did not differ between patients with (20.7%) or without (25.8%) foot pump use. This study shows that the A-V Impulse system foot pump did not affect the incidence of DVT under edoxaban thromboprophylaxis in patients undergoing TKA. Seroconversion of anti-PF4/heparin antibodies was detected in a significant number of patients who underwent TKA under antithrombotic prophylaxis using edoxaban.
記述: 長崎大学学位論文 学位記番号:博(医歯薬)甲第986号 学位授与年月日:平成29年9月20日 / Author: Sakai, Tatsuya; Izumi, Masahiro; Kumagai, Kenji; Kidera, Kenichi; Yamaguchi, Takayuki; Asahara, Tomohiko; Kozuru, Hideko; Jiuchi, Yuka; Mawatari, Masaaki; Osaki, Makoto; Motokawa, Satoru; Migita, Kiyoshi / Citation: Medicine, 95(1), e2247; 2016
URI: http://hdl.handle.net/10069/37827
ISSN: 00257974
DOI: 10.1097/MD.0000000000002247
関連リンク : http://hdl.handle.net/10069/37797
権利: © 2016 Wolters Kluwer Health, Inc. All rights reserved. This is an open access article distributed under the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
資料タイプ: Thesis or Dissertation
原稿種類: ETD
出現コレクション:110 学位論文

引用URI : http://hdl.handle.net/10069/37827



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