Ambulatory cancer patients: who should definitely receive antithrombotic prophylaxis and who should never receive

Verso, Melina; Muñoz, Andrés; Connors, Jean M.

doi:10.1007/s11739-023-03306-8

Cited by 2 publications

(1 citation statement)

References 79 publications

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“…Notably, for cancer patients with a heightened risk of bleeding, such as those with brain cancer, moderate-to-severe thrombocytopenia, or severe renal impairment, it is not advisable to pursue primary prevention of VTE. In cases where patients present with absolute contraindications for anticoagulation therapy, such as active bleeding or severe long-term thrombocytopenia, inferior vena cava filter implantation may be considered based on specific circumstances[ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Challenging anticoagulation therapy for multiple primary malignant tumors combined with thrombosis: A case report and review of literature

Chen,

Xu,

Cheng

et al. 2024

World J Clin Cases

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BACKGROUND Venous thromboembolism significantly contributes to patient deterioration and mortality. Management of its etiology and anticoagulation treatment is intricate, necessitating a comprehensive consideration of various factors, including the bleeding risk, dosage, specific anticoagulant medications, and duration of therapy. Herein, a case of lower extremity thrombosis with multiple primary malignant tumors and high risk of bleeding was reviewed to summarize the shortcomings of treatment and prudent anticoagulation experience. CASE SUMMARY An 83-year-old female patient was admitted to the hospital due to a 2-wk history of left lower extremity edema that had worsened over 2 d. Considering her medical history and relevant post-admission investigations, it was determined that the development of left lower extremity venous thrombosis and pulmonary embolism in this case could be attributed to a combination of factors, including multiple primary malignant tumors, iliac venous compression syndrome, previous novel coronavirus infection, and inadequate treatment for prior thrombotic events. However, the selection of appropriate anticoagulant medications, determination of optimal drug dosages, and establishment of an appropriate duration of anticoagulation therapy were important because of concurrent thrombocytopenia, decreased quantitative fibrinogen levels, and renal insufficiency. CONCLUSION Anticoagulant prophylaxis should be promptly initiated in cases of high-risk thrombosis. Individualized anticoagulation therapy is required for complex thrombosis.

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Section: Discussionmentioning

confidence: 99%

Challenging anticoagulation therapy for multiple primary malignant tumors combined with thrombosis: A case report and review of literature

Chen,

Xu,

Cheng

et al. 2024

World J Clin Cases

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Provoked vs minimally provoked vs unprovoked VTE: does it matter?

Becattini,

Cimini

2023

Hematology

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Venous thromboembolism (VTE) is a multifactorial disease, and its risk depends on exposure to risk factors and predisposing conditions. Based on their strength of association with a VTE episode, risk factors are classified as major or minor and determined using a temporal pattern to be transient or persistent. All patients with VTE should receive anticoagulant treatment for at least 3 months in the absence of an absolute contraindication. Beyond this period, selected patients may be candidates for an extended phase of anticoagulation aimed at secondary VTE prevention. The risk of recurrent VTE if anticoagulation is discontinued is probably the main driver of decision-making regarding extended treatment. The risk of recurrence after VTE associated with major risk factors is low if the risk factor is no longer present. In this case, treatment can be discontinued. If the major risk factor is persistent, anticoagulation should be continued. After VTE occurring in the absence of risk factors, anticoagulation should probably be continued indefinitely if the risk for bleeding is low and preferably with minimal effective doses of anticoagulants. VTE occurring after exposure to minor risk factors is probably the most challenging situation, especially if the clinical manifestation was acute pulmonary embolism. Understanding the actual role of minor risk factors in the occurrence of VTE helps in estimating the risk of recurrence and avoiding the dangers associated with unnecessary anticoagulation. The availability of safer strategies for anticoagulation could allow personalized strategies for secondary prevention of VTE.

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Ambulatory cancer patients: who should definitely receive antithrombotic prophylaxis and who should never receive

Cited by 2 publications

References 79 publications

Challenging anticoagulation therapy for multiple primary malignant tumors combined with thrombosis: A case report and review of literature

Challenging anticoagulation therapy for multiple primary malignant tumors combined with thrombosis: A case report and review of literature

Provoked vs minimally provoked vs unprovoked VTE: does it matter?

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