January 19, 2016
Updated recommendations are highlighted in this guideline for the treatment of patients with venous thromboembolism (VTE). Among the updated recommendations are:
Citation:
Updated recommendations are highlighted in this guideline for the treatment of patients with venous thromboembolism (VTE). Among the updated recommendations are:
- For VTE in patients who do not have cancer, as long-term anticoagulant therapy, dabigatran, rivaroxaban, apixaban, or edoxaban is suggested over VKA (vitamin K antagonist i.e., warfarin) therapy, and VKA therapy is suggested over LMWH.
- For patients with isolated distal DVT who do not have severe symptoms or risk factors for extension serial imaging of the deep veins for 2 weeks is recommended over anticoagulation.
- For DVT, the guidelines suggest not using compression stockings routinely to prevent PTS.
- For subsegmental PE and no proximal DVT, clinical surveillance is suggested over anticoagulation in patients with a low risk of recurrent VTE.
- Thrombolytic therapy is indicated only for pulmonary embolus with hypotension. Systemic therapy is recommended over catheter directed thrombolysis.
- In patients who do not continue extended anticoagulation after VTE, aspirin may be used to decrease recurrence by about one-third, compared to the 80% decrease with full anticoagulation.
- Recommendations for who should stop anticoagulation at 3 months or receive extended therapy have not changed.
Citation:
- Kearon O, Aki EA, Ornelas J, et al. Antithrombotic therapy for VTE disease: CHEST guideline. Chest. 2016. doi:10.1016/j.chest.2015.11.026.
