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Thrombosis prophylaxis is effective in preventing the formation of blood clots, their lodging in the veins, and their developing into thromboemboli that can travel through the circulatory system to cause blockage and subsequent tissue death in other organs. [1] Clarence Crafoord is credited with the first use of thrombosis prophylaxis in the 1930s.
The conditions of DVT only, DVT with PE, and PE only, are all captured by the term venous thromboembolism (VTE). [ 2 ] The initial treatment for VTE is typically either low-molecular-weight heparin (LMWH) or unfractionated heparin , or increasingly with direct acting oral anticoagulants (DOAC).
Warfarin, dabigatran, and edoxaban require the use of a parenteral anticoagulant to initiate oral anticoagulant therapy. [19] [125] When warfarin is initiated for VTE treatment, a 5-day minimum of a parenteral anticoagulant [j] together with warfarin is given, which is followed by warfarin-only therapy.
Warfarin is indicated for the prophylaxis and treatment of venous thrombosis and its extension, pulmonary embolism; [9] prophylaxis and treatment of thromboembolic complications associated with atrial fibrillation and/or cardiac valve replacement; [9] and reduction in the risk of death, recurrent myocardial infarction, and thromboembolic events such as stroke or systemic embolization after ...
Patients with cancer are at higher risk of venous thromboembolism, and LMWHs are used to reduce this risk. [10] The CLOT study, published in 2003, showed that dalteparin was more effective in patients with malignancy and acute venous thromboembolism than warfarin in reducing the risk of recurrent embolic events. [11]
Pharmacological (warfarin, unfractionated heparin, low molecular weight heparin) and mechanical measures (graded compression stockings, intermittent pneumatic compression devices, and venous foot pumps) are used to prevent venous thromboembolism (VTE) in clinical practice.
Desirudin is approved for treatment of venous thromboembolism (VTE) in Europe and multiple phase III trials are presently ongoing in the USA. [4] Two studies comparing desirudin with enoxaparin (a LMWH) or unfractionated heparin have been performed. In both studies desirudin was considered to be superior in preventing VTE.
The CLOT study, published in 2003, showed that in patients with malignancy and acute venous thromboembolism (VTE), dalteparin was more effective than warfarin in reducing the risk of recurrent embolic events. [4] Dalteparin is not superior to unfractionated heparin in preventing blood clots. [5]