Anticoagulant treatment of deep vein thrombosis in ambulatory practice

Czech version

Authors: D. Karetová
Authors‘ workplace: II. interní klinika kardiologie a angiologie 1. lékařské fakulty UK a VFN, Praha, přednosta prof. MUDr. Michael Aschermann, DrSc., FESC
Published in: Vnitř Lék 2005; 91(7 a 8): 790-794
Category: 128th Internal Medicine Day - 21rd Vanysek's Day Brno 2005

Overview

A classical anticoagulation therapy in acute phases of venous thromboses is especially based on low-molecular weight heparin (LMWH) administration today. Treatment with non-fractionated heparin is indicated only exclusively, in particular in situations where the increased risk of bleeding or the necessity of performing surgery or other intervention is being expected. LMWH administration resulted in general improvement of the care for patients with deep vein thromboses. We reach an efficient therapy in most patients without necessity of laboratory monitoring, only with dosage depending on patient's body weight. Subcutaneous administration 1-times or 2-times daily is simple and more comfortable for patients compared to continual infusion. Some defined cases of deep vein thromboses are indicated to administration of thrombolytic treatment (younger patients with the first attack of ileofemoral thrombosis without significant associated diseases). In rare cases of contraindications of anticoagulant (and concurrently thrombolytic) treatment it is possible to consider surgical thrombectomy in the case of recent thrombosis, however low-molecular weight heparins are currently the basis of treatment in most patients. A finding that walk does not increase the risk of pulmonary embolism occurrence and simultaneously leads to faster oedema and pain regression enabled treatment transfer of the part of non-complicated patients to the ambulatory scope.

Key words:
thromboembolic disease –⁠ low-molecular weight heparin –⁠ ambulatory treatment of thromboses

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