Dabigatran etexilate, a novel oral direct thrombin inhibitor, for preventing thromboembolic events after knee replacement arthroplasty

Background: Dabigatran etexilate is one of the few direct thrombin inhibitors with anti-coagulant activities and the following distinctive features: taken orally, no need to closely monitor for complications, and no need for regular dose adjustments. Relying on the above mentioned valuable advantages, dabigatran etexilate can be considered as a premier choice for the prevention of venous thromboembolism after knee replacement arthroplasty. Methods: Forty five patients undergoing 50 knee replacement surgeries were included in this case-series study undertaken in Hazrat Rasool Akram and Khatam-alanbia Hospitals during 2010. Dabigatran etexilate was administered for the prevention of venous thromboembolism after knee arthroplasty in doses of 110 mg in the first 1-4 h after surgery followed by daily doses of 220 mg for 10 days. Patients were examined 3 times and a color Doppler sonography was performed on the 11th day to check for venous thrombosis. Finally, the patients were re-examined at the end of the 1st and the 3rd months postoperatively. Results: Only one out of 45 patients was diagnosed to have venous thrombosis on sonography done on the 11th day but the patient did not have any symptoms and repeat sonographies at the end of the 1st and the 3rd months postoperatively showed no venous thrombosis either. No complications were witnessed in the patients in the 3-month follow-up period. Conclusion: Dabigatran etexilate (220 mg/d for 10 days) can be an effective drug against venous thrombosis after total knee replacement surgeries