ESA and iron enhance surgery outcomesUse of preoperative erythropoietin-stimulating agents is associated with decreased thrombotic adverse events compared to red blood cell transfusion in surgical patients with anaemia.
Evaluates cardiovascular surgical risks
We aimed to understand how preoperative treatments like erythropoietin-stimulating agents (ESAs) and intravenous (IV) iron influence the risk of blood clots in surgical patients dealing with anaemia.
In our investigation, we found that patients who received ESAs—whether accompanied by IV iron or not—had lower risks of serious post-operative complications, including blood clots, compared to those who were given red blood cell transfusions. Specifically, those treated with ESAs without IV iron showed significant reductions in mortality and the occurrence of venous thromboembolic events.
Interestingly, when IV iron was combined with ESAs, it appeared to further enhance outcomes, notably improving survival rates. Our results suggest that combining these treatments might yield benefits for patients undergoing surgery, reflected in higher haemoglobin levels and fewer complications compared to traditional blood transfusions.
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Iron's unclear role in DVTMay-Thurner Syndrome: An Unusual Case of Unilateral Severe Deep Vein Thrombosis in a Middle-Aged Women.
Limited effectiveness of iron therapy
We explored a 50-year-old woman who came to us with noticeable swelling and pain in her left leg lasting ten days. Upon evaluation, we found that she had deep vein thrombosis (DVT) associated with May-Thurner Syndrome (MTS), where a vein is compressed by an artery. Initially, her blood tests showed normocytic anemia, yet the tests for blood clotting disorders returned normal.
Treatment began with anticoagulation therapy using enoxaparin, coupled with iron supplementation. While iron is typically known for helping with anemia, its specific effect on blood clot resolution in this case remains unclear. Our patient's initial treatments were expanded to include catheter-directed thrombolysis to dissolve the clot, followed by a procedure to relieve venous compression.
We observed significant success in reducing the thrombus burden and restoring blood flow post-stenting. However, we noted that the role of iron supplementation alone in treating the blood clot is ambiguous when combined with other therapies. Thus, while iron is essential for overall health and could play a supportive role, its independent effectiveness against DVT is undetermined in this scenario.
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