Martínez-Murillo C, Aguilar-Arteaga ML, Velasco-Ortega E, Alonso-González R, Castellanos-Sinco H, Romo-Jiménez A, Vargas-Ruiz A, Torres-Arreola L, Viniegra-Osorio A

Idioma: Español
Referencias bibliográficas: 44
Paginas: 437-449
Archivo PDF: 68.29 Kb.

RESUMEN

Objetivo: estandarizar los diferentes protocolos y estrategias de manejo asociadas con la trombosis venos profunda y el embolismo pulmonar y sus complicaciones.
Métodos: se formularon preguntas clínicas concretas y estructuradas sobre diagnóstico y tratamiento de la trombosis. Se estableció una secuencia estandarizada para la búsqueda de guías de práctica clínica. Se encontraron siete guías, de las cuales se tomó gran parte de las recomendaciones; la búsqueda de las recomendaciones no incluidas en las guías de referencia se llevó a cabo en PubMed y Cochrane Library Plus. Los resultados se expresaron en niveles de evidencia y grado de recomendación, de acuerdo con las características del diseño y el tipo de estudio.
Conclusiones: los criterios de riesgo y el diagnóstico correcto permiten establecer la tromboprofilaxis y la terapia específica para los eventos trombóticos. Esta guía se funda en una recopilación y análisis de las guías internacionales más importantes, así como de metaanálisis y artículos de revisión sobre trombosis venosa, y pone al alcance del personal médico las recomendaciones basadas en evidencias, con la finalidad de tomar decisiones estandarizadas de diagnóstico y tratamiento, para disminuir la morbilidad y mortalidad en los pacientes con trombosis venosa.

REFERENCIAS (EN ESTE ARTÍCULO)

1. Dahlback B. Advances in understanding pathogenic mechanisms of thrombophilic disorders. Blood 2008;112 (1):19-27.

2. Heit JA. The epidemiology of venous thrombolism in the community:implicatios for prevention and management. J Thromb Thrombolysis 2006;21(1):23-29.

3. Cohen AT, Agnelli G, Anderson FA, Arcelus JI, Berqvist D, Brecht JG, et al. Venous thromboembolism in Europe. Thromb Haemost 2007;98(4):756-764.

4. 4 Anderson FA, Spencer FA. Risk factors for venous thromboembolism. Circulation 2003;107:1-9.

5. Caprini JA, Arcelus JI, Hasty JH, Tamhane AC, Fabrega F. Clinical assessment of venous thromboembolic risk in surgical patients. Semin Thromb Hemost 1991;17(Suppl 3):304-312.

6. Torres-Arreola LP, Peralta-Pedrero ML, Viniegra-Osorio A, Valenzuela-Flores AA, Echevarría-Zuno S, Sandoval- Castellanos FJ. Proyecto para el desarrollo de guías de práctica clínica en el Instituto Mexicano del Seguro Social. Rev Med Inst Mex Seguro Soc 2010;48(6):661-672.

7. Caprini JA. Risk assessment as a guide to thrombosis prophylaxis. Curr Opin Pulm Med 2010;16(5):448-452.

8. Wells PS, Anderson DR, Bormanis J, Guy F, Mitchell M, Gray L, et al. Value of assessment of pretest probability of deep-vein thrombosis in clinical management. Lancet 1997;350(9094):1795-1798.

9. Wells PS, Ginsberg JS, Anderson DR, Kearon C, Gent M, Turpie AG, et al. Use of a clinical model for safe management of patients with suspected pulmonary embolism. Ann Intern Med 1998;129(12):997-1005.

10. Wells PS, Hirsh J, Anderson DR, Lensing AW, Foster G, Kearon C, et al. Accuracy of clinical assessment of deepvein thrombosis. Lancet 1995;345(8961):1326-1330.

11. Goodacre S, Sampson F, Stevenson M, Wailoo A, Sutton A, Thomas S, et al. Measurement of the clinical and costeffectiveness of non-invasive diagnostic testing strategies for deep vein thrombosis. Health Technol Asses 2006;10 (15):37-42.

12. Di Nisio M, Squizato A, Rutjes WS, Buller HR, Zwinderman AH, Bossuyt MM. Diagnostic accuracy of D-dimer test for exclusión of venous thromboembolism: a systematic review. J Thromb Haemost 2006;5(2):296-304.

13. Righini M, Perrier A, De Moerloose P, Bounameaux H. Ddimer for venous thromboembolism diagnosis: 20 years later. J Thromb Haemost 2008;6(7):1059-1071.

14. Nomura H, Wada H, Mizuno T, Katayama N, Abe Y, Noda M, et al. Negative predictive value of d-dimer for diagnosis of venous thromboembolism. Int J Hematol 2008;87 (3):250-255.

15. Wells PS, Anderson DR, Rodger M, Ginsberg JS, Kearon C, Gent M, et al. Derivation of a simple clinical model to categorize patients probability of pulmonary embolism: increasing the models utility with the SimpliRED D-dimer. Thromb Haemost 2000;83(3):416-420.

16. Kassai B, Boissel JP, Cucherat M, Sonie S, Shah NR, Leizorovicz A. A systematic review of the accuracy of ultrasound in the diagnosis of deep venous trombosis in asymptomatic patients. Thromb Haemost 2004;91(4):655-666.

17. Thomas SM, Goodacre SW, Sampson FC, van Beek EJR. Diagnostic value of CT for deep vein trombosis: results of a systematic review and meta-analysis. Clin Radiol 2008;63(3):299-304.

18. Sampson FC, Goodacre SW, Thromas SM, Van Beeck EJ. The accuracy of MRI in diagnosis of suspected deep vein trombosis:systematic review and meta-analysis. Eur Radiol 2007;17(1):175-181.

19. Lozano F. Actualización en trombosis venosa profunda que afecta a las extremidades inferiores; diagnóstico. Angiologia 2003;55(5):476-487.

20. Perrier A. Pulmonary embolism: from clinical presentation to clinical probability assessment. Semin Vasc Med 2001;1(2):147-154.

21. Kearon C, Kahn SR, Agnelli G, Goldhaber S, Raskob GE, Comerota AJ; American College of Chest Physicians. Antithrombotic therapy for venous thromboembolic disease. American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008; 133(6 Suppl):454S–545S

22. Geerts WH, Bergqvist D, Pineo GF, Heit JA, Samama CM, Lassen MR, et al. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008;133(6 Suppl):381S-453S.

23. Dolovich LR, Ginsberg JS, Douketis JD, Holbrook AM, Cheah G. A meta-analysis comparing low-molecular weight heparins with unfractionated heparin in the treatment of venous thromboembolism. Arch Intern Med 2000; 160(2):181-188.

24. Lindmarker P, Schulman S. The risk of ipsilateral versus contralateral recurrent deep vein thrombosis in the leg. The DURAC Trial Study Group. J Intern Med 2000;247 (5):601-606.

25. Palareti G, Cosmi B, Legnani C, et al. PROLONG Investigators. D-dimer testing to determine the duration of anticoagulation therapy. N Engl J Med 2006;355(17): 1780-1789.

26. Cosmi B, Legnani C, Tosetto A, Pengo V, Ghirarduzzi A, Alatri A, et al. Use of D-dimer testing to determine duration of anticoagulation, risk of cardiovascular events and occult cancer after a first episode of idiopathic venous thromboembolism: the extended follow-up of the PROLONG Study. J Thromb Thrombolysis 2009;28(4): 381-388.

27. EINSTEIN Investigators. Oral Rivaroxaban for symptomatic venous thromboembolism. N Engl J Med 2010;363(26): 2499-2510.

28. Schulman S, Kearon C, Kakkar AJ, Mismetti P, Schellong S, Eriksson H, et al. Dabigatran versus warfarin in the treatment of acute venous thromboembolism. N Engl J Med 2009;361(24):2342-2352.

29. Rasmussen MS, Jorgensen LN, Wille-Jørgensen P. Prolonged thromboprophylaxis with low molecular weight heparin for abdominal or pelvic surgery. Cochrane Database of Syst Rev 2009;1:1-17.

30. Rodger A, Walker N. Reduction of postoperative mortality and morbidity with epidural or spinal anesthesia: results of overview of randomized trials. BMJ 2000;321 (7275):1493-1497.

31. Gogarten W, Vandermeulen E, Van Aken H, Kozek S, Llau JV, Samama CM; European Scoeity of Anaesthesiology. Regional anesthesia and antithrombotic agents: recomendations of the European society of anesthesiology. Eur J Anestesiol 2010;27(12):999-1015.

32. Eriksson BI, Borris LC, Friedman RJ, Haas S, Huisman MV, Kakkar AK, et al. Rivaroxaban versus enoxaparin for thromboprophylaxis after hip athroplasty. N Engl J Med 2008; 358(26):2765-2775.

33. Kakkar AK, Brenner B, Dahl OE, Eriksson BI, Mouret P, Muntz J, et al.; RECORD2 Investigators. Extended duration rivaroxaban versus short-term enoxaparin for the prevention of venous thromboembolism after total hip arthroplasty: a double-blind, randomized controlled trial. Lancet 2008; 372(9632):31-39.

34. Eriksson BI, Dahl OE, Rosencher N, Kurth AA, Niek van Dijk C, Frostick SP, et al. Dabigatran etexilate versus enoxaparin for prevention of venous thromboembolism after total hip replacement: a randomised, double-blind, non-inferiority trial. Lancet 2007;370(9591):949-956.

35. Eriksson BI, Dahl OE, Rosencher N, Kurth AA, van Dijk CN, Frostick SP,et al.; RENOVATE Study Group. Dabigatran etexilate versus enoxaparin for prevention of venous thromboembolism after total hip replacement a randomized, double-blind, non-inferiority trial. Lancet 2007;370 (9591):949-956.

36. Bauer KA, Eriksson BI, Lassen MR, for the Steering Committee of the Pentasaccharide in Major Knee Surgery Study. Fondaprinux compared with enoxaparin for the prevention of venous thromboembolism after elective major knee surgery. N Engl J Med 2001;345(18):1305-1310.

37. Turpie AG, Lassen MR, Eriksson BI, Gent M, Berkowitz SD, Misselwitz F, et al. Rivaroxaban for the prevention of venous thromboembolism after hip or knee arthroplasty. Pooled analysis of four studies. Thromb Haemost 2011; 105(3):444-53.

38. Lassen MR, Ageno W, Borris LC, Lieberman JR, Rosencher N, Bandel TJ, et al.; RECORD3 Investigators Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty. N Engl J Med 2008;358(26): 2776-2786.

39. Turpie AG, Lassen MR, Davidson BL, Bauer KA, Gent M, Kwong LM, et al.; RECORD4 Investigators. Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty (RECORD4): a randomized trial. Lancet 2009; 373(9676):1673-1680.

40. Eriksson BI, Dahl OE, Rosencher N, Kurth AA, van Dijk CN, Frostick SP, et al. RE-MODEL Study Group. Oral dabigatran etexilate vs subcutaneous enoxaparin for the prevention of venous thromboembolism alter total knee replacement the RE-MODEL randomized trial. J Thromb Haemost 2007;5(11)2178-2185.

41. RE-MOBILIZE Writing Committee, Ginsberg JS, Davidson BL, Comp PC, Francis CW, Friedman RJ, Huo MH, et al. Oral thrombin inhibitor dabigatran etexilate vs North American enoxaparina regimen for prevention of venous thrombo-embolism after knee artrhoplasty surgery. J Arthroplasty 2009;1:1-9.

42. McCullagh L, Tilson L, Walshi C, Barry M. A cost-effective- nness model comparing rivaroxaban and dabigatran etexilate with enoxaparin sodium as thromboprophylaxis after total hip and total knee replacement in the Irish Healthcare Setting. Pharmacoeconomics 2009;27(10): 829-846.

43. Eikelboom JW, Weitz JI. New oral anticoagulants for thromboprophylaxis in patients having hip or knee arthroplasty. BMJ 2010:342(7270):224-229.

44. Diamantopoulos A, Lees M, Wells PS, Forster F, Ananthapavan J, McDonald H. Cost-effectiveness of rivaro-xabán versus enoxaparina for the prevention of postsurgical venous thromboembolism in Canada. Thromb Haemost 2010; 104(4):760-770.