Low dose heparin in the prevention of deep-vein thrombosis after aortic bifurcation graft surgery.

In a randomised double-blind controlled trial 24 patients undergoing elective aortic bifurcation graft surgery received subcutaneous calcium heparin (2,500 u pre-operatively then 5,000 u 12-hourly for 7 days) and 25 control patients received saline injections. All patients received a routine dose of intravenous sodium heparin intra-operatively. The trial was terminated because of excess bleeding complications in patients receiving subcutaneous heparin (8 vs. 1, p less than 0.05). Deep vein thrombosis occurred in 6 control patients and 2 patients on heparin (p less than 0.05). In this group of patients undergoing major vascular surgery the risk of bleeding due to heparin outweighed the potential benefit of thrombotic prophylaxis.