Avidan 2011.

Methods	Randomised, double‐blind study
Participants	Adult patients (n = 120) scheduled for elective cardiac (n = 40) or thoracic surgery (n = 80)
Interventions	Intervention: desirudin (Iprivask; Canyon Pharmaceuticals, Hunt Valley, Maryland) 15 mg sc twice daily Control: unfractionated heparin 5000 units sc thrice daily with saline placebo given once daily Duration of thrombosis prophylaxis was determined by the treating physician Quote: "Both treatment groups also received mechanical prophylaxis via sequential compression devices. All patients who underwent cardiac surgery received heparin during the procedure. For these patients, enrolment into the study occurred if thrombosis prophylaxis was required at any time from postoperative day 1 through the end of hospitalization and if no exclusion criteria were met. Thoracic surgery patients who were assigned to the heparin treatment arm received heparin during the procedure; those assigned to the desirudin arm received desirudin during the procedure. For these patients, enrolment occurred when the patient received the first dose of thrombosis prophylaxis either pre‐ or intra‐operatively."
Outcomes	Primary outcome: incidence of new antibody formation directed against platelet factor 4 (PF4)/heparin complex Secondary outcomes included bleeding and thrombotic complications (symptomatic and asymptomatic deep vein thrombosis or symptomatic pulmonary embolism)
Notes	This study included patients undergoing surgery types representing exclusion criteria for this review. The authors have been contacted to try to obtain data for the patients matching the review inclusion criteria