Low molecular weight heparin (enoxaparin) versus dextran in the prevention of early occlusion following arterial bypass surgery distal to the groin

• AIM: to compare the effect of perioperative dextran and low molecular weight heparin on early graft patency after femorodistal bypass surgery. DESIGN: prospective randomised multicentre study. PATIENTS AND METHODS: three hundred and fourteen patients were randomised to dextran 70 or the low molecular weight heparin enoxaparin during and after femorodistal bypass surgery. Patency was evaluated at days 1, 5-7, 30 and 90. RESULTS: there was no difference in patency at any time point between the two regimens, the crude 90 days patency being 88 and 83%, respectively. There were significantly more patients with heart failure in the dextran group (12.8 vs 0.7%), with other side effects being evenly distributed. CONCLUSION: dextran 70 and the low molecular weight heparin enoxaparin have the same effect on 90 days femorodistal graft patency, but care must be taken using the dextran to patients with a potential heart insufficiency.

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