الفهرس 
Pathology of Venous ThromboembolismOnly 14 pages are availabe for public view
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Abstract
T
SOAs offer several clear advantages to traditional antithrombotic agents including rapid onset of action, short half-life, predictable pharmacokinetics and pharmacodynamics, and minimal drug-drug interactions.
TSOAs as Dabigatran, rivaroxaban, and apixaban have been approved for thromboprophylaxis after THA in many countries, while rivaroxaban and apixaban are currently the only agents approved by the FDA in the United States, and a fourth additional agent, edoxaban, has been approved only in Japan for this indication.
By looking at the study this comparison revealed the high efficacy of TSOAs over enoxaparin regarding the dose and its route of administration which is the oral route that is much easier for the patient than the subcutaneous injection of the enoxaparin.
The safety of TSOAs is higher than enoxaparin in patients suffering from hepatic or renal impairments in addition to it’s fewer drug interactions that can cause many problems.
We also found no difference in the incidence of wound infection by using either TSOAs or enoxaparin .
The main conclusion that we can get from studies and researches is that the incidence of deep venous thrombosis is higher with the use of enoxaparin than with TSOAs.
By decreasing the incidence of deep venous thrombosis there is also a remarkable lowering in the incidence of pulmonary embolism which may cause lung infarction and may lead to death if massive infarction occurred.
Regarding the occurrence of major bleeding which also can occur from the wound, It is found that TSOAs has caused more major bleedings than enoxaparin and this is found to be the only disadvantage of rivaroxaban in its comparison with enoxaparin.
After total arthroplasty either total hip replacement or total knee, it is more preferable to give the patient TSOAs from 2 weeks up to 5 weeks post operative in addition to early ambulation of the patient as early as we can so that the incidence of deep venous thrombosis and its complication is lowered as possible.
By giving the patient rivaroxaban, we must monitor the patient closely in the first two weeks for fear of the occurrence of major bleeding which may occur from the wound site.
TSOAs have provided safe and effective options for thromboprophylaxis after THA and represent a cost-effective alternative to the most widely used LMWH class of anticoagulants. Although long-term clinical experience is lacking, and the ability to reliably monitor or reverse the anticoagulant effect of the agents is still under development, TSOAs have established a new approach to thromboprophylaxis after THA.