Enoxaparin in the Prevention of Deep Vein Thrombosis in Patients with Acute Ischemic Stroke

Abstract

Background: Deep vein thrombosis (DVT) is a severe complication in patients with acute ischemic stroke. It can cause severe pulmonary embolism, which may result in death. DVT prevalence in ischemic stroke patients ranges from 20 to 70%. Enoxaparin in prophylactic treatment can decrease the risk of developing DVT in patients with acute ischemic stroke. However, optimal enoxaparin dosing for prophylactic treatment in DVT remains elusive. Dosing between 0.3 - 0.5 IU/mL could decrease the prevalence of DVT without increased complications. Objectives: This study aims to evaluate the benefits and risks of prophylactic treatment in DVT patients with dosing of enoxaparin (Lovenox of Sanofi-Aventis Vietnam Company) 40 mg (4,000 units of anti-Xa, 0.4 mL) once daily. Methods: Following a cross-sectional design, 58 patients with acute ischemic stroke, who met the inclusion criteria, were studied. Participants received prophylactic treatment of the lower extremities DVT with enoxaparin. Results: The mean Wells score was 2.14 ± 0.35. Based on the Wells criteria for DVT, all cases had paralysis, muscle weakness, and bedridden recently > 3 days. Also, 4 cases (6.9%) had leg edema; 1 case (1.7%) had superficial collateral veins; 3 cases (5.3%) had previously documented DVT. Thrombocytopenia > 50% after treatment has a non-statistically significant decrease. The 2nd ultrasound showed no case of DVT. Conclusions: Enoxaparin was not the primary cause of thrombocytopenia in prophylactic treatment. Enoxaparin is a 100% effective means to prevent lower extremity DVT in average-risk patients, and it does not increase the risk of bleeding.