Prevention of thromboembolism.

Abstract

Recently much attention has been focused on the high incidence of thromboembolism following major hip surgery–and in particular total hip reconstruction. Mortality is at least 1.8% following total hip replacement in the absence of prophylaxis. Because of the difficulties encountered with use of anticoagulants such as warfarin sodium and heparin sodium, attention has been turned toward the dextran solutions as antiplatelet agents. Basic, however, to the use of an antiplatelet agent to prevent thromboembolism is an understanding of the central role of the platelet in thrombogenesis. Histopathologic studies have shown that the development of a mural platelet thrombus is the first stage of thrombus formation, not only in the arterial but also in the venous system. A number of studies have further shown that many patients who develop thromboemboli show an abnormality in platelet adhesiveness. The available evidence suggests that the activation of the venous thrombus may follow the formation