Pharmacological Agents for DVT Prophylaxis

Anticoagulants can prevent thrombi from forming in the deep veins of the leg; however, they can also lead to serious complications such as excessive bleeding (e.g., intracerebral hemorrhaging.

The consortium for spinal cord medicine published clinical practice guidelines for the prevention of thromboembolism in SCI (2008). The clinical practise guidelines recommend to:

“Begin low molecular weight heparin, or unfractionated heparin plus intermittent pneumatic  compression, in all patients when primary hemostasis becomes evident. Intracranial bleeding,  perispinal hematoma, or hemothorax are potential contraindications to the administration of  anticoagulants, but anticoagulants may be appropriate when bleeding has stabilized” (p. 38).

This recommendation is based on studies that showed that the risk of thromboembolism in SCI increases rapidly after injury and is maximal between days 7 and 10 (Chiou-Tan et al. 2003; Green et al. 1982; Merli et al. 1988; Geerts et al. 1994).