Venous thromboembolism: A clinical review

Olusegun Osinbowale, Lobna Ali, Yung-wei Chi

Research output: Contribution to journalArticle

27 Scopus citations

Abstract

Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism, represents a signifi cant source of morbidity and mortality. It is readily diagnosed with noninvasive modalities when there is a clinical suspicion. Most patients presenting with signs and symptoms of DVT have well-known risk factors, such as a history of VTE, malignancy, recent illness, or immobilization. A subset of individuals with idiopathic VTE have no readily identifi - able risk factors. Therapeutic anticoagulation is the cornerstone of management in all patients with VTE. Adjunctive measures, such as thrombolysis and the use of vena cava fi lters, are indicated in select cases. The ideal duration of anticoagulation is unknown, but is often maintained long-term in patients with acquired or inherited thrombophilia. Warfarin is the only oral anticoagulant approved by the US Food and Drug Administration. Warfarin carries a substantial annual risk of bleeding complications, requires ongoing monitoring, and has extensive drug-drug interactions, which are causes for concern in patients requiring long-term anticoagulation. Alternative oral anticoagulants, such as direct thrombin inhibitors and factor Xa inhibitors, are subjects of active research in alternative agents for oral anticoagulation, and have been recently approved for prophylaxis in Canada and the European Union.

Original languageEnglish (US)
Pages (from-to)54-65
Number of pages12
JournalPostgraduate Medicine
Volume122
Issue number2
DOIs
StatePublished - Mar 2010
Externally publishedYes

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Keywords

  • Anticoagulation
  • Deep vein thrombosis
  • Heparin
  • Low-molecular-weight heparin
  • Pulmonary embolism
  • Venous thromboembolism
  • Warfarin

ASJC Scopus subject areas

  • Medicine(all)

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