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VTE DVT anticoagulation treatment duration

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https://www.readbyqxmd.com/read/29222260/should-we-diagnose-and-treat-distal-deep-vein-thrombosis
#1
REVIEW
Helia Robert-Ebadi, Marc Righini
Ultrasound series report that isolated distal deep vein thrombosis (DVT), also known as calf DVT, represents up to 50% of all lower-limb DVTs and, therefore, is a frequent medical condition. Unlike proximal DVT and pulmonary embolism, which have been studied extensively and for which management is well standardized, much less is known about the optimal management of isolated calf DVT. Recent data arising from registries and nonrandomized studies have suggested that most distal DVTs do not extend to the proximal veins and have an uneventful follow-up when left untreated...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29127473/colorectal-cancer-and-thrombosis
#2
P A Rees, H W Clouston, S Duff, C C Kirwan
SIGNIFICANCE: Colorectal cancer (CRC), results in a hypercoagulable state which manifests clinically as venous thromboembolism (VTE), often presenting as a deep vein thrombosis (DVT) or pulmonary embolism (PE). The consequences of VTE in CRC can be devastating, resulting in long-term morbidity and are a frequent cause of death, even amongst those who would have otherwise had a favourable cancer prognosis. The incidence of VTE in all cancers is increasing, whilst the exact incidence of VTE in CRC is likely to be underestimated...
November 10, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28119956/analysis-of-clinical-factors-affecting-the-rates-of-fatal-pulmonary-embolism-and-bleeding-in-cancer-patients-with-venous-thromboembolism
#3
Javier Trujillo-Santos, Francisco Martín Martos, Carme Font, Dominique Farge-Bancel, Vladimir Rosa, Alicia Lorenzo, Manuel Barrón, Manuel Alejandro Lorente, José María Pedrajas, Manuel Monreal
BACKGROUND: In cancer patients with symptomatic venous thromboembolism (VTE) (deep-vein thrombosis (DVT) and/or pulmonary embolism (PE)), clinical factors that influence the benefit-risk balance of anticoagulation need to be identified so treatment intensity and duration can be optimally adjusted for the individual patient. METHODS: Using clinical data for cancer patients with VTE obtained from the RIETE registry, we compared how rates of fatal PE and fatal bleeding during and after anticoagulation vary depending on patients' clinical characteristics...
January 2017: Heliyon
https://www.readbyqxmd.com/read/27987605/analysis-of-noncatheter-associated-upper-extremity-deep-venous-thrombosis-from-the-riete-registry
#4
Daniel H Newton, Manuel Monreal Bosch, Michael Amendola, Luke Wolfe, Cristina Perez Ductor, Ramón Lecumberri, Mark M Levy
OBJECTIVE: We sought to determine the risk factors for subsequent bleeding and recurrent venous thromboembolism (VTE) events following isolated noncatheter-associated upper extremity deep venous thrombosis (non-CA-UEDVT) to better inform future treatment decisions for this group of patients. METHODS: The RIETE registry (Registro Informatizado de Enfermedad TromboEmbólica [Computerized Registry of Patients with Venous Thromboembolism]) is a prospective international registry of patients with objectively confirmed symptomatic VTE...
January 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/27889688/management-of-distal-deep-vein-thrombosis
#5
REVIEW
Helia Robert-Ebadi, Marc Righini
Isolated distal deep vein thrombosis (DVT), also known as calf DVT, represents up to 50% of all lower limb DVT in ultrasound series and is therefore a frequent medical condition. Unlike proximal DVT and pulmonary embolism (PE), which have been extensively studied and for which management is well standardized, much less is known on the optimal management of isolated calf DVT. Recent data arising from registries and non-randomized studies suggest that most distal DVTs do not extend to the proximal veins and have an uneventful follow-up when left untreated...
January 2017: Thrombosis Research
https://www.readbyqxmd.com/read/27886530/choosing-wisely-the-impact-of-patient-selection-on-efficacy-and-safety-outcomes-in-the-einstein-dvt-pe-and-amplify-trials
#6
Jan Beyer-Westendorf, Anthonie W A Lensing, Roopen Arya, Henri Bounameaux, Alexander T Cohen, Philip S Wells, Saskia Middeldorp, Peter Verhamme, Rodney Hughes, Nils Kucher, Akos F Pap, Mila Trajanovic, Martin H Prins, Paolo Prandoni, Jeffrey I Weitz
BACKGROUND: The results of the EINSTEIN-DVT/PE and AMPLIFY trials, which compared rivaroxaban and apixaban with conventional anticoagulation therapy for acute venous thromboembolism (VTE), respectively, are often compared. However, the trials differed in duration of therapy (3-12 and 6months, respectively) and in patient selection (few exclusion criteria and more stringent exclusion criteria, respectively). METHODS: To determine the effect of these methodological differences on outcomes, the patients enrolled in EINSTEIN-DVT/PE were divided into 2 cohorts; the 5253 patients that matched the exclusion criteria for AMPLIFY and were treated for at least 6months (cohort 1) and the 2368 patients who would have been ineligible for AMPLIFY (cohort 2)...
January 2017: Thrombosis Research
https://www.readbyqxmd.com/read/27623682/spotlight-on-advances-in-vte-management-callisto-and-einstein-choice
#7
Miriam Bach, Rupert Bauersachs
Venous thromboembolism (VTE) is associated with numerous complications and high mortality rates. Patients with cancer are at high risk of developing cancer-associated thrombosis (CAT), and VTE recurrence is common. Evidence supporting use of non-vitamin K antagonist (VKA) oral anticoagulants (NOACs) in patients with cancer is lacking - direct comparisons between NOACs and low-molecular-weight heparin (LMWH) are needed, along with patient-reported outcomes. Cancer Associated thrombosis - expLoring soLutions for patients through Treatment and Prevention with RivarOxaban (CALLISTO) is an international research programme exploring the potential of the direct, oral factor Xa inhibitor rivaroxaban for the prevention and treatment of CAT, supplementing existing data from EINSTEIN DVT and EINSTEIN PE...
September 28, 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/27161683/oc-11-anticoagulation-therapy-in-selected-cancer-patients-at-risk-of-recurrence-of-venous-thromboembolism
#8
A Young, J Phillips, H Hancocks, C Hill, N Joshi, A Marshall, J Grumett, J A Dunn, A Lokare, O Chapman
INTRODUCTION: Venous thromboembolism (VTE) in cancer patients is an increasingly frequent clinical problem. The overall impact of VTE on cancer patients can be considerable. Targeted patient selection by identifying patients with clinically significant recurrent VTE may have wider health economic benefits whilst reducing patient risk through over-treatment. In the UK, dalteparin is one licensed anticoagulant for the extended treatment and prevention of recurrence of VTE in cancer patients...
April 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27161673/oc-01-clinical-history-of-cancer-patients-with-isolated-distal-deep-vein-thrombosis-a-multicenter-cohort-study
#9
F Dentali, S Pegoraro, S Barco, M N D di Minno, D Mastroiacovo, F Pomero, C Lodigiani, F Bagna, M Sartori, G Barillari, N Mumoli, M Napolitano, S Passamonti, R Benedetti, W Ageno, M Di Nisio
INTRODUCTION: Isolated distal deep vein thrombosis (IDDVT) accounts for one-fourth to one-half of all deep vein thrombosis (DVT) of the leg. Patients with IDDVT are frequently treated for a shorter period of time compared to patients with proximal DVT and/or pulmonary embolism (PE) due to a perceived lower risk of recurrence. About 10-20% of patients with venous thromboembolic events (VTEs) have concomitant cancer. Guidelines recommend long-term anticoagulant treatment in this group of patients due to their high risk of VTE recurrence...
April 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27027384/anticoagulants-extended-duration-for-prevention-of-venous-thromboembolism-following-total-hip-or-knee-replacement-or-hip-fracture-repair
#10
REVIEW
Rachel Forster, Marlene Stewart
BACKGROUND: The optimal duration of thromboprophylaxis after total hip or knee replacement, or hip fracture repair remains controversial. It is common practice to administer prophylaxis using low-molecular-weight heparin (LMWH) or unfractionated heparin (UFH) until discharge from hospital, usually seven to 14 days after surgery. International guidelines recommend extending thromboprophylaxis for up to 35 days following major orthopaedic surgery but the recommendation is weak due to moderate quality evidence...
March 30, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26992315/duplex-imaging-of-residual-venous-obstruction-to-guide-duration-of-therapy-for-lower-extremity-deep-venous-thrombosis
#11
REVIEW
Elliot J P Stephenson, Timothy K Liem
BACKGROUND: Clinical trials have shown that the presence of ultrasound-identified residual venous obstruction (RVO) on follow-up scanning may be associated with an elevated risk for recurrence, thus providing a potential tool to help determine the optimal duration of anticoagulant therapy. We performed a systematic review to evaluate the clinical utility of post-treatment duplex imaging in predicting venous thromboembolism (VTE) recurrence and in adjusting duration of anticoagulation...
July 2015: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/26984241/adherence-to-treatment-guidelines-for-cancer-associated-thrombosis-a-french-hospital-based-cohort-study
#12
I Mahé, H Puget, J C Buzzi, M Lamuraglia, J Chidiac, A Strukov, Hélène Helfer, A Perozziello
PURPOSE: French 2008 treatment guidelines recommend low-molecular-weight heparins (LMWH) for the treatment of cancer-associated thrombosis (CAT) with treatment duration of at least 3 months and up to 6 months and beyond if cancer remains active. Our aim was to assess adherence to guidelines in hospital clinical practice. METHODS: The French hospital database (PMSI) was used to identify patients with CAT admitted to three hospitals of the Paris region to be included in a retrospective cohort study...
August 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/26822633/warfarin-initiation-nomograms-for-venous-thromboembolism
#13
REVIEW
Pedro Garcia, Wilson Ruiz, César Loza Munárriz
BACKGROUND: Venous thromboembolism (VTE) is a common condition in hospital patients. Considerable controversy is ongoing regarding optimal initial warfarin dosing for patients with acute deep venous thrombosis (DVT) and pulmonary embolism (PE). Achieving a therapeutic international normalized ratio (INR) with warfarin as soon as possible is important because this minimizes the duration of parenteral medication necessary to attain immediate anticoagulation, and it potentially decreases the cost and inconvenience of treatment...
January 29, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26780738/guidance-for-the-treatment-of-deep-vein-thrombosis-and-pulmonary-embolism
#14
REVIEW
Michael B Streiff, Giancarlo Agnelli, Jean M Connors, Mark Crowther, Sabine Eichinger, Renato Lopes, Robert D McBane, Stephan Moll, Jack Ansell
This guidance document focuses on the diagnosis and treatment of venous thromboembolism (VTE). Efficient, cost effective diagnosis of VTE is facilitated by combining medical history and physical examination with pre-test probability models, D dimer testing and selective use of confirmatory imaging. Clinical prediction rules, biomarkers and imaging can be used to tailor therapy to disease severity. Anticoagulation options for acute VTE include unfractionated heparin, low molecular weight heparin, fondaparinux and the direct oral anticoagulants (DOACs)...
January 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/26765080/comparison-of-four-bleeding-risk-scores-to-identify-rivaroxaban-treated-patients-with-venous-thromboembolism-at-low-risk-for-major-bleeding
#15
COMPARATIVE STUDY
Jeffrey A Kline, David Jimenez, D Mark Courtney, Juliana Ianus, Lynn Cao, Anthonie W A Lensing, Martin H Prins, Philip S Wells
OBJECTIVES: Outpatient treatment of acute venous thromboembolism (VTE) requires the selection of patients with a low risk of bleeding during the first few weeks of anticoagulation. The accuracy of four systems, originally derived for predicting bleeding in VTE treated with vitamin K antagonists (VKAs), was assessed in VTE patients treated with rivaroxaban. METHODS: All patients treated with rivaroxaban in the multinational EINSTEIN deep vein thrombosis (DVT) and pulmonary embolism (PE) trials were included...
February 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/26664901/anticoagulant-treatment-of-deep-vein-thrombosis-and-pulmonary-embolism-the-present-state-of-the-art
#16
REVIEW
Johannes Thaler, Ingrid Pabinger, Cihan Ay
Venous thromboembolism (VTE), a disease entity comprising deep vein thrombosis (DVT) and pulmonary embolism (PE), is a frequent and potentially life-threatening event. To date different agents are available for the effective treatment of acute VTE and the prevention of recurrence. For several years, the standard of care was the subcutaneous application of a low molecular weight heparin (LMWH) or fondaparinux, followed by a vitamin K antagonist (VKA). The so-called direct oral anticoagulants (DOAC) were introduced rather recently in clinical practice for the treatment of VTE...
2015: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/26606049/treating-patients-with-cancer-and-acute-venous-thromboembolism
#17
REVIEW
Marco P Donadini, Alessandro Squizzato, Walter Ageno
INTRODUCTION: Cancer and venous thromboembolism (VTE) are closely related, with a high risk of VTE associated with cancer and a strong impact of VTE on cancer prognosis. The management and treatment of cancer-associated VTE are particularly challenging and, in many cases, are not guided by a high level of evidence. AREAS COVERED: In this review, we present the best therapeutic approach to acute deep vein thrombosis (DVT) and pulmonary embolism (PE) and to some controversial issues, such as home treatment, optimal duration of anticoagulation, management of VTE recurrence during anticoagulant treatment, and of unsuspected PE...
2016: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/26587983/extended-anticoagulant-and-aspirin-treatment-for-the-secondary-prevention-of-thromboembolic-disease-a-systematic-review-and-meta-analysis
#18
REVIEW
Paul E Marik, Rodrigo Cavallazzi
BACKGROUND: Patients who have had an unprovoked deep venous thrombosis (DVT) or pulmonary embolus (PE) are at a high risk for recurrent venous thromboembolism (VTE). Extended "life-long" anticoagulation has been recommended in these patients. However, the risk benefit ratio of this approach is controversial and the role of the direct oral anticoagulants (DOACs) and aspirin is unclear. Furthermore, in some patients with a "weak provoking factor" there is clinical equipoise regarding continuation or cessation of anticoagulant therapy after treatment of the acute VTE event...
2015: PloS One
https://www.readbyqxmd.com/read/26455025/-pulmonary-embolism-in-pregnancy
#19
REVIEW
Anna Polewczyk, Marcin Sadowski
Pulmonary embolism (PE) is very rarely observed during pregnancy and postpartum period. The frequency of PE in pregnant women is relatively difficult to assess because the existing data estimate all venous-thromboembolic (VTE) complications including deep venous thrombosis (DVT) and PE. The incidence of PE itself has been evaluated on 3 cases per 10000 deliveries. Diagnostics of PE during pregnancy is very difficult and requires unequivocal confirmation or exclusion because of exposure of fetus to potential complications of antithrombic therapy...
2015: Przegla̧d Lekarski
https://www.readbyqxmd.com/read/26422329/rate-and-duration-of-hospitalization-for-deep-vein-thrombosis-and-pulmonary-embolism-in-real-world-clinical-practice
#20
MULTICENTER STUDY
Francesco Dentali, Gianluca Di Micco, Matteo Giorgi Pierfranceschi, Gualberto Gussoni, Giovanni Barillari, Maria Amitrano, Andrea Fontanella, Corrado Lodigiani, Anna Guida, Adriana Visonà, Manuel Monreal, Pierpaolo Di Micco
BACKGROUND: Current guidelines recommend initial treatment with anticoagulants at home in patients with acute deep vein thrombosis (DVT) and in patients with low-risk pulmonary embolism (PE) with adequate home circumstances. However, most of the patients with acute venous thromboembolism (VTE) are currently hospitalized regardless of their risk of short-term complications. AIM OF THE STUDY: To assess the proportion of outpatients with acute VTE initially treated in hospitals, to assess the mean duration of hospitalization, and to identify predictors for in-hospital or home treatment...
2015: Annals of Medicine
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