[Contemporary approaches to determine the duration of anticoagulant therapy for venous thromboembolism].

Abstract

The review is devoted to the issue of optimal duration of anticoagulant therapy for venous thromboembolic complications (VTEC) using oral anticoagulants (OAC). These drugs are characterized by higher safety in comparison with vitamin K antagonists and make it possible to increase the duration of treatment for not only spontaneous thrombosis (with high risk of recurrence), but also thrombosis provoked by minor persistent and transient risk factors of VTEC. Efficacy and safety of prolonged treatment of VTEC using OAC was analyzed. Different classifications of primary thrombotic episode depending on risk of subsequent recurrence are presented. Moreover, scales for individual assessment of risk of recurrent thrombosis after anticoagulant therapy cancellation and risk of bleeding in case of continued treatment are given. Outcomes of long-term administration of rivaroxaban for VTEC are analyzed. It was concluded that OAC are safe for prolonged management of primary thrombotic episode. However, overall duration of treatment should be determined considering individual balance of benefits and risks.

• Authors: K V Lobastov
• Journal: Khirurgiia (Khirurgiia (Mosk)) Issue 5 Pg. 94-103 ( 2019) ISSN: 0023-1207 [Print] Russia (Federation)
• Vernacular Title: Sovremennye podkhody k opredeleniiu dlitel'nosti antikoaguliantnoĭ terapii venoznykh tromboémbolicheskikh oslozhneniĭ.
• PMID: 31169827 (Publication Type: Journal Article, Review)

Chemical References

• Anticoagulants
• Factor Xa Inhibitors
• Rivaroxaban

Topics

• Anticoagulants (administration & dosage, adverse effects, therapeutic use)
• Drug Administration Schedule
• Factor Xa Inhibitors (administration & dosage, adverse effects, therapeutic use)
• Hemorrhage (chemically induced)
• Humans
• Recurrence
• Risk Factors
• Rivaroxaban (administration & dosage, adverse effects, therapeutic use)
• Thrombosis (etiology)
• Time Factors
• Venous Thromboembolism (drug therapy)
• Withholding Treatment