Evidence brief
Aspirin for VTE Prophylaxis in Total Joint Arthroplasty
Aspirin non-inferior to rivaroxaban for symptomatic VTE prevention
After initial 5 days of rivaroxaban, aspirin 81mg as effective
VTE rate: 0.64% aspirin vs 0.70% rivaroxaban
Major bleeding similar between groups
Supports aspirin as cost-effective alternative
The EPCAT II trial supports aspirin as a simple, cost-effective option for extended VTE prophylaxis after arthroplasty, following a short course of more potent anticoagulation.
Know current VTE prophylaxis options: aspirin emerging as acceptable (EPCAT II, AAOS guidelines), LMWH remains common, DOACs effective. Discuss risk stratification, duration (35 days), and balancing bleeding vs thrombosis risk.
Level I
Systematic review of RCTs or high-quality RCT