Via practica 6/2021

Long-term anticoagulation therapy following deep vein thrombosis

In many cases, venous thromboembolism (VTE) is a chronic, recurring condition; therefore, secondary thromboprophylaxis of varying duration is always required. The duration and method of thromboprophylaxis depends on the attending physician’s decision upon agreement with the patient. Secondary thromboprophylaxis should last at least three months. Afterwards, based on evaluation of factors determining the individual risk of VTE recurrence and bleeding, a decision has to be made on treatment termination or continuation. Extended anticoagulant therapy (no scheduled stop date) should be used preferably in patients who had no major bleeding with anticoagulation therapy during a period of three months, are concerned about VTE recurrence rather than bleeding, have a persistent major risk factor, venous malformation, antiphospholipid syndrome, serious laboratory thrombophilia, or have experienced VTE repeatedly.

Keywords: thromboembolic disease, deep vein thrombosis, pulmonary embolism, secondary thromboprophylaxis, D-dimers, DOAK, sulodexide, acetylsalicylic acid