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Management of venous thromboembolism: an update

Venous thromboembolism (VTE), which constitutes pulmonary embolism and deep vein thrombosis, is a common disorder associated with significant morbidity and mortality. Landmark trials have shown that direct oral anticoagulants (DOACs) are as effective as conventional anticoagulation with vitamin K an...

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Autores principales: Piran, Siavash, Schulman, Sam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5056465/
https://www.ncbi.nlm.nih.gov/pubmed/27766049
http://dx.doi.org/10.1186/s12959-016-0107-z
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author Piran, Siavash
Schulman, Sam
author_facet Piran, Siavash
Schulman, Sam
author_sort Piran, Siavash
collection PubMed
description Venous thromboembolism (VTE), which constitutes pulmonary embolism and deep vein thrombosis, is a common disorder associated with significant morbidity and mortality. Landmark trials have shown that direct oral anticoagulants (DOACs) are as effective as conventional anticoagulation with vitamin K antagonists (VKA) in prevention of VTE recurrence and associated with less bleeding. This has paved the way for the recently published guidelines to change their recommendations in favor of DOACs in acute and long-term treatment of VTE in patients without cancer. The recommended treatment of VTE in cancer patients remains low-molecular-weight heparin. The initial management of pulmonary embolism (PE) should be directed based on established risk stratification scores. Thrombolysis is an available option for patients with hemodynamically significant PE. Recent data suggests that low-risk patients with acute PE can safely be treated as outpatients if home circumstances are adequate. There is lack of support for use of inferior vena cava filters in patients on anticoagulation. This review describes the acute, long-term, and extended treatment of VTE and recent evidence on the management of sub-segmental PE.
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spelling pubmed-50564652016-10-20 Management of venous thromboembolism: an update Piran, Siavash Schulman, Sam Thromb J Review Venous thromboembolism (VTE), which constitutes pulmonary embolism and deep vein thrombosis, is a common disorder associated with significant morbidity and mortality. Landmark trials have shown that direct oral anticoagulants (DOACs) are as effective as conventional anticoagulation with vitamin K antagonists (VKA) in prevention of VTE recurrence and associated with less bleeding. This has paved the way for the recently published guidelines to change their recommendations in favor of DOACs in acute and long-term treatment of VTE in patients without cancer. The recommended treatment of VTE in cancer patients remains low-molecular-weight heparin. The initial management of pulmonary embolism (PE) should be directed based on established risk stratification scores. Thrombolysis is an available option for patients with hemodynamically significant PE. Recent data suggests that low-risk patients with acute PE can safely be treated as outpatients if home circumstances are adequate. There is lack of support for use of inferior vena cava filters in patients on anticoagulation. This review describes the acute, long-term, and extended treatment of VTE and recent evidence on the management of sub-segmental PE. BioMed Central 2016-10-04 /pmc/articles/PMC5056465/ /pubmed/27766049 http://dx.doi.org/10.1186/s12959-016-0107-z Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Review
Piran, Siavash
Schulman, Sam
Management of venous thromboembolism: an update
title Management of venous thromboembolism: an update
title_full Management of venous thromboembolism: an update
title_fullStr Management of venous thromboembolism: an update
title_full_unstemmed Management of venous thromboembolism: an update
title_short Management of venous thromboembolism: an update
title_sort management of venous thromboembolism: an update
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5056465/
https://www.ncbi.nlm.nih.gov/pubmed/27766049
http://dx.doi.org/10.1186/s12959-016-0107-z
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