Anticoagulation treatment for acute venous thromboembolism

The immediate goal of treatment for acute venous thromboembolism(VTE) is to prevent pulmonary embolism(PE),reduce morbidity and to limit the size of the clot,relief symptom and prevention of deep vein thrombosis(DVT) recurrence,chronic venous insufficiency and postphlebitic syndrome.Anticoagulation for DVT and PE consists of parenteral administration of heparin or low-molecular-weight heparin overlapped and followed by oral vitamin K antagonists.This treatment is highly efficacious in preventing recurrent VTE events but not devoid of bleeding risk.The clinical decision for duration of anticoagulation therapy in an individual patient depends upon the estimated risks of VTE recurrence and treatment-induced bleeding.The risk of VTE recurrence is higher in idiopathic events.Therapeutic recommendations may be with shorter duration in case of transient risk factor,or increased bleeding risk,and longer duration in case of a recurrent unprovoked event,especially if permanent risk factors are present.