Avtor/Urednik		Prandoni, P
Naslov		The optimal treatment of venous thrombosis
Tip		članek
Vir		In: Pathophysiological, clinical and laboratory aspects of thromboembolic disease. Proceedings of the 8th advanced teaching course in thrombosis and haemostasis; 2001 Mar 22-27; Kranjska gora. Ljubljana: University medical center, Department of angiology,
Leto izdaje		2001
Obseg		str. 171-9
Jezik		eng
Abstrakt		Unfractionated heparin in adjusted doses and low-molecular-weight heparins in fixed dose represent the therapy of choice for the initial treatment of venous thromboembolism. The use of standard heparin protocols assures that virtually all patients will achieve the therapeutic range for the activated partial thromboplastin time thereby decreasing the likelihood of recurrent venous thromboembolism with no added risk of bleeding complications. However, proper use of unfractionated heparin requires considerable expertise, can cause inconvenience and has limitations. The use of low-molecular-weight heparins has multiple advantages over unfractionated heparin. These drugs exhibit a more predictable dose-response, and can be administered in fixed doses. Unmonitored therapy with subcutaneous low-molecular-weight heparins is at least as effective as adjusted-dose standard heparin in terms of reduction of recurrent venous thromboembolism is probably safer with respect to major bleeding, as is associated with a statistically significant reduction in total mortality, which is mainly due to a prolonged survival in cancer patients. A number of randomized clinical trials and prospective cohort studies have convincingly demonstrated that the treatment of suitable patients in an outpatient setting is feasible, safe and is associated with a substantial cost saving. Recent studies have shown that low-molecular-weight heparins are at least as effective and safe as unfractionated heparin also for the treatment of non-critical patients with pulmonary embolism: Whether home treatment of pulmonary embolism is feasible and safe remains to be demonstrated. The optimal duration of oral anticoagulant therapy following the initial treatment of venous thromboembolism is still controversial.
Deskriptorji		THROMBOPHLEBITIS HEPARIN PARTIAL THROMBOPLASTIN TIME HEPARIN, LOW-MOLECULAR-WEIGHT PULMONARY EMBOLISM TREATMENT OUTCOME