Need for Long-Term Anticoagulant Treatment in Symptomatic Calf-Vein Thrombosis

Lagerstedt, C; Olsson, Carl; Fagher, Birger; Öqvist, Björn; Albrechtsson, U.

doi:10.1016/s0140-6736(85)90459-3

Cited by 535 publications

(265 citation statements)

References 18 publications

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“…However, 10% of patients in the study developed pulmonary emboli. In a randomized clinical trial, Lagerstedt et al 47 reported a 29% recurrence rate in patients with symptomatic calf DVT treated with 5 days of intermittent heparin. Kakkar and Lawrence 48 repeated phlebography 5 to 7 days after diagnosis of calf DVT and discovered that thromboses had propagated in 10% of patients despite heparin treatment, ha a careful analysis of 20 relevant articles concerning calf DVT, Philbrick and Becker 49 concluded that thromboses propagate to the thigh in about 20% of cases and that propagation invariably occurs before embolization.…”

Section: Discussionmentioning

confidence: 99%

Propagation of deep venous thrombosis identified by duplex ultrasonography

Krupski

Bass

Dilley

et al. 1990

Journal of Vascular Surgery

113

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Section: Discussionmentioning

confidence: 99%

Propagation of deep venous thrombosis identified by duplex ultrasonography

Krupski

Bass

Dilley

et al. 1990

Journal of Vascular Surgery

113

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“…For most patients it is recommended to be continued for 3 months [8,75]. This approach is supported by 2 studies by Hull et al who demonstrated low rates of recurrent thrombosis in patients with proximal DVT who received 3 months of OAT [67,71].…”

Section: 5 Duration Of Secondary Prophylaxismentioning

confidence: 96%

New developments in the treatment of deep venous thrombosis

Janssen¹,

Nováková²,

Verbruggen³

et al. 1997

The Netherlands Journal of Medicine

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An initial course of standard heparin (SH) or low-molecular-weight heparins (LMWH) is regarded as the treatment of choice for patients with deep venous thrombosis (DVT). LMWH have better bioavailability after subcutaneous administra tion, have a longer half-life, and show higher and more predictable anticoagulant activity. As a result they can be given subcutaneously and without laboratory control, using a dose that is determined by body weight. Because of these multiple advantages of LMWH they will replace SH in the future and subsequently home treatment with LMWH of selected patients seems feasible. The currently accepted approach is to start with SH or LMWH therapy combined with oral anticoagulant therapy (OAT) at the time of diagnosis. The course of SH or LMWH should continue for at least 5 days, provided that international normalized ratio (INR) is in the therapeutic range on 2 consecutive days. OAT should be continued for at least 3 months to prolong the prothrombin time to an INR of 2 -3 . When oral anticoagulants are either contraindicated or inconvenient, SH or LMWH can be used at the middosing interval. The role of anti-platelet treatment is not yet established 4 and should be compared with coumarin therapy in the future.

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“…Several studies have confirmed that a rapidly initiated, intensive anticoagulation approach reduces the risk of recurrent venous thromboembolic events, [12][13][14][15][16] particularly in the initial phase (eg, immediate action with low molecular weight heparin (LMWH) overlapping with and followed by a sloweracting VKA has been shown to be effective). 2,12,13,17,18) Postthrombotic syndrome, a long-term thromboembolic complication associated with VTE, may also be prevented by the immediate use of an anticoagulant. 19,20) The THRIVE study showed numerically more recurrences for patients receiving a maintenance dose of the direct thrombin inhibitor ximelagatran 36 mg twice daily (bid) compared with an intensive treatment group (heparin overlapping with a VKA).…”

Section: Enous Thromboembolism (Vte) Comprising Deepmentioning

confidence: 99%

Overview of Current Evidence on the Impact of the Initial High Dose of the Direct Factor Xa Inhibitor Rivaroxaban on Thrombus Resolution in the Treatment of Venous Thromboembolism

Bauersachs

Koitabashi

2017

Int. Heart J.

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SummaryIncomplete thrombus resolution in patients with venous thromboembolism (VTE) may increase the risk of recurrent thromboembolic events and other complications, such as post-thrombotic syndrome. Various options exist for thrombus resolution, including systemic thrombolytic agents, catheter-directed thrombolysis, and traditional anticoagulants such as heparins or vitamin K antagonists (VKAs). Data are accumulating on the use of non-VKA oral anticoagulants, such as rivaroxaban, and these may provide greater thrombus resolution compared with VKAs. Data from the phase III rivaroxaban studies presented here show that a 21-day intensive dosing regimen of rivaroxaban 15 mg twice daily is effective during the acute treatment phase for VTE, with similar recurrence rates and thrombus resolution to standard anticoagulation. Pooled analyses of phase III studies have also indicated that rivaroxaban 20 mg once daily monotherapy for up to 12 months after this initial intensive treatment period may provide effective prevention of recurrent VTE and a reduction in the risk of major bleeding, irrespective of clot burden. Four case studies from the Darmstadt Academic Teaching Hospital, Germany, and Gunma University Hospital, Japan, are also provided. Further clinical studies and real-world data may improve our understanding of initial intensive dose regimens, and assess the full significance of thrombus burden in VTE. (Int Heart J 2017; 58: 6-15)

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Need for Long-Term Anticoagulant Treatment in Symptomatic Calf-Vein Thrombosis

Cited by 535 publications

References 18 publications

Propagation of deep venous thrombosis identified by duplex ultrasonography

Propagation of deep venous thrombosis identified by duplex ultrasonography

New developments in the treatment of deep venous thrombosis

Overview of Current Evidence on the Impact of the Initial High Dose of the Direct Factor Xa Inhibitor Rivaroxaban on Thrombus Resolution in the Treatment of Venous Thromboembolism

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