|Beitragstitel||Venous Thromboembolism Prophylaxis with Rivaroxaban in Elective Foot and Ankle Surgery|
Oral application for prophylaxis of venous thromboembolism (VTE) after total hip and knee arthroplasty has high
acceptance among patients due to its non-invasive nature, when compared to traditional subcutaneous application of lowmolecular-
weight heparin (LMWH). Approximately 10% of the patients in our clinic receive oral thrombosis prophylaxis
(rivaroxaban), the remaining patients receive subcutaneous prophylaxis with LMWH (dalteparin). However, no clinical
data exists describing the use of oral prophylaxis in elective orthopedic foot and ankle surgery.
The aims of this study where:
1. To assess the incidence of VTE after oral prophylaxis after elective foot and ankle procedures.
2. To identify risk factors for VTE after oral prophylaxis after elective foot and ankle procedures.
A retrospective chart review of patients undergoing elective foot and ankle surgery between January 2010 and 2013 was
performed. The type of medicamentous thrombosis prophylaxis was noted. All patients receiving oral antithrombotic
medication (rivaroxaban, XareltoÂ©, Bayer, Germany) were included in the study. Location, length and type of surgery
and tourniquet time were assessed. Co-morbidities (e.g. diabetes, coagulopathy, ASA classification) were noted. Patients
previously treated with phenprocoumon or clopidrogel were excluded. A phone interview was performed and patients
were asked whether a thromboembolic incident occurred or not. If an incidence was reported, the report of the diagnostic
findings was obtained from the general practitioner.
450 patients were included. Two thromboembolic incidents occurred (0.4%; deep venous thrombosis confirmed by
ultrasound). Both patients had a history of previous deep venous thrombosis and a positive family history for VTE. Due to
the percentage of patients with VTE, a multivariate analysis could not be performed.
DISCUSSION AND CONCLUSION:
The incidence of VTE after oral thrombosis prophylaxis with rivaroxaban is low and comparable with the incidence after
subcutaneous application of LMWH.