Abstract
We report three elderly patients with deep vein thrombosis (DVT) who responded well to subcutaneous administration of fondaparinux as the initial treatment, along with a brief review of the relevant literature. All three patients were women, aged 89 years 11 months, 89 years 6 months, and 76 years old. After lower limb DVT complicated by pulmonary arterial embolism was diagnosed by computed tomography (CT), the patients were started on treatment with subcutaneous injections of fondaparinux. At the same time, oral warfarin treatment was also started. The fondaparinux treatment was discontinued when satisfactory increase of the prothrombin time-international normalized ratio was confirmed. Two patients also required a temporary inferior vena cava filter. The duration of fondaparinux treatment was 10 days, 8 days and 10 days in the three patients. CT performed 1 week after the start of treatment revealed resolution of the pulmonary embolism and lower limb DVT in all three patients, along with improvement of the lower limb symptoms. Moreover, there were no complications such as hemorrhage, and all of the patients were discharged from the hospital in good general condition. In general, urokinase infusion and warfarin are used for the treatment of DVT. However, in patients with a high risk of hemorrhage, such as elderly patients, and in those with relatively mild deep vein thrombosis, subcutaneous administration of fondaparinux also appears to be effective for obtaining improvement of the subjective symptoms and radiological resolution or reduction of the thrombosis, allowing early ambulation and prevention of other clinical complications specific to elderly patients.
