dicumarol and Arterial-Occlusive-Diseases

The effect of coumarin on patency, limb salvage, and survival after primary femoro-popliteal and femoro-distal reconstructions was studied in 116 randomized patients (61 in the study group and 55 in the control group). All patients were treated postoperatively with heparin. Patients allocated to the study group received dicumarol (a coumarin derivative) orally postoperatively. The overall patency after 1 year was 75 +/- 6%, compared with 74 +/- 6%, after 2 years 65 +/- 9 compared with 57 +/- 8%, and after 3 years 46 +/- 11% compared with 42 +/- 9% (mean +/- SE) in the study and control groups, respectively. There were no statistically significant differences in limb salvage or survival rates between the two groups. In contrast, coumarin treatment was associated with serious bleeding complications in 4% to 5% of the study patients. As expected, limb salvage was lower in patients with critical ischemia (p less than 0.03), and this was also true for survival (p less than 0.04), which was also influenced by the level of the reconstruction; survival was lower in patients with femoro-distal reconstructions (p less than 0.001). Our results demonstrate that coumarin treatment does not improve outcome in routine femoro-popliteal and femoro-distal reconstructive surgery.

Topics: Adult; Aged; Aged, 80 and over; Arterial Occlusive Diseases; Blood Vessel Prosthesis; Coumarins; Dicumarol; Female; Follow-Up Studies; Heparin; Humans; Intermittent Claudication; Leg; Male; Middle Aged; Postoperative Care; Randomized Controlled Trials as Topic; Saphenous Vein; Time Factors

Topics: Adult; Age Factors; Aged; Arterial Occlusive Diseases; Dicumarol; Female; Femoral Fractures; Fibrin; Fibrinogen; Half-Life; Heparin; Humans; Iodine Radioisotopes; Male; Middle Aged; Postoperative Care; Tibial Fractures; Time Factors

327 patients with peripheral arteriopathy were treated solely with protracted dicoumarol anticoagulant therapy. The indication for such therapy was applied not only in patients in whom the high risk and poor run-off contraindicated revascularisation operations, but also in those in good general conditions at the 2nd or 3rd stage with iliac and femoral thromboses. Two-thirds of the arteriopathics observed were given the anticoagulant treatment for more than two years, with a maximum of eight years. Clinical evolution of the disease is discussed in relation to the treated patients' age and stage, while emphasis is given to the very low incidence of complications and contraindications, despite the long period of treatment.

Topics: Adult; Aged; Arterial Occlusive Diseases; Dicumarol; Female; Humans; Leg; Male; Middle Aged

Topics: Anticoagulants; Aortic Aneurysm; Aortic Diseases; Aortic Rupture; Arterial Occlusive Diseases; Arteriosclerosis Obliterans; Dicumarol; Femoral Artery; Humans; Iliac Artery; Popliteal Artery; Sympathectomy; Vasodilator Agents

Topics: Adult; Aged; Angiography; Arterial Occlusive Diseases; Catheterization; Dicumarol; Female; Femoral Artery; Follow-Up Studies; Germany, West; Heparin; Humans; Male; Middle Aged; Popliteal Artery; Postoperative Complications; Streptokinase