Evidence-Based Therapies for Pharmacologic Prevention and Treatment of Acute Deep Vein Thrombosis and Pulmonary Embolism

Abstract

Venous thromboembolism (VTE) remains a significant mortal and morbid disease. The major risks have not changed and many patients present with unprovoked VTE disease. Prevention of VTE in hospitalized patients depends on comprehensive risk factor assessment, with an individual risk score. Proper and timely prophylaxis with mechanical, pharmacologic, or both is then effective. Treatment of VTE with parenteral anticoagulation followed by either a direct oral anticoagulant or warfarin is standard to reduce risk of VTE recurrence and death. Selected cases of iliofemoral deep vein thrombosis may be treated by pharmacomechanical thrombolysis, but more data are needed before this is standard of care.

Keywords: Anticoagulation; Deep vein thrombosis; Pulmonary embolism; Risk prediction; Thrombolysis; Venous thromboembolism.