Pulmonary Embolism While on Aspirin for Venous Thromboembolism Prophylaxis After Total Knee Arthroplasty

Journal of Primary Care & Community Health
Francisco RomanKathy MacLaughlin

Abstract

A 62-year-old Caucasian man with past medical history significant for coronary artery disease, status post drug eluting stent to the left anterior descending artery 10 years prior, was admitted for elective total right knee arthroplasty. His intraoperative course was uneventful, and he was discharged on hospital day 2 on aspirin 325 mg twice daily for 6 weeks for venous thromboembolism (VTE) prophylaxis. Three weeks later the patient developed chest pain shortly after an approximately 1-hour flight and presented to a local emergency department where computed tomography angiogram showed pulmonary emboli involving segmental and subsegmental pulmonary arteries bilaterally. He was transitioned from aspirin 325 mg twice a day to rivaroxaban 15 mg twice daily for 21 days, with a plan to transition to 20 mg daily to complete a 3-month course. He returned to his primary care physician 6 days after discharge with questions about his current anticoagulation therapy as well as the regimen he was on prior to the pulmonary embolism. Two major organizations, The American Academy of Orthopedic Surgeons and The American College of Chest Physicians, provide recommendations for VTE prophylaxis, but they differ regarding the preferred pharmacolog...Continue Reading

References

Sep 16, 2000·The Journal of Bone and Joint Surgery. British Volume·G H WestrichM Peterson
Apr 18, 2001·The Journal of Arthroplasty·K R BrookenthalJ H Lonner
Jun 27, 2008·The New England Journal of Medicine·Bengt I ErikssonUNKNOWN RECORD1 Study Group
Jun 27, 2008·The New England Journal of Medicine·Michael R LassenUNKNOWN RECORD3 Investigators
Jul 2, 2009·The Journal of Bone and Joint Surgery. British Volume·S HuZ-D Cai
Aug 7, 2009·The New England Journal of Medicine·Michael Rud LassenRonald J Portman
Aug 15, 2009·The Journal of Arthroplasty·Kevin J BozicAndrew D Auerbach
Dec 24, 2010·The New England Journal of Medicine·Michael Rud LassenUNKNOWN ADVANCE-3 Investigators
Jul 3, 2013·Clinical Orthopaedics and Related Research·Ibrahim J RaphaelJavad Parvizi
Jun 2, 2017·Clinical Orthopaedics and Related Research·Abiram BalaDerek F Amanatullah

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Methods Mentioned

BETA
total hip arthroplasty

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