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Lobastov K.V.

Kafedra obshcheĭ khirurgii lechebnogo fakul'teta GOU VPO RGMU Roszdrava, Moskva

Contemporary approaches to determine the duration of anticoagulant therapy for venous thromboembolism

Authors:

Lobastov K.V.

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Journal: Pirogov Russian Journal of Surgery. 2019;(5): 94‑103

DOI: 10.17116/hirurgia201905194

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Lobastov KV. Contemporary approaches to determine the duration of anticoagulant therapy for venous thromboembolism. Pirogov Russian Journal of Surgery. 2019;(5):94‑103. (In Russ.)
https://doi.org/10.17116/hirurgia201905194

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The review is devoted to the issue of optimal duration of anticoagulant therapy for venous thromboembolic complications (VTEC) using oral anticoagulants (OAC). These drugs are characterized by higher safety in comparison with vitamin K antagonists and make it possible to increase the duration of treatment for not only spontaneous thrombosis (with high risk of recurrence), but also thrombosis provoked by minor persistent and transient risk factors of VTEC. Efficacy and safety of prolonged treatment of VTEC using OAC was analyzed. Different classifications of primary thrombotic episode depending on risk of subsequent recurrence are presented. Moreover, scales for individual assessment of risk of recurrent thrombosis after anticoagulant therapy cancellation and risk of bleeding in case of continued treatment are given. Outcomes of long-term administration of rivaroxaban for VTEC are analyzed. It was concluded that OAC are safe for prolonged management of primary thrombotic episode. However, overall duration of treatment should be determined considering individual balance of benefits and risks.

Keywords:

venous thrombosis
venous thrombosis
pulmonary embolism
pulmonary embolism
anticoagulant therapy
anticoagulant therapy
duration
duration
oral anticoagulants
oral anticoagulants

Authors:

Lobastov K.V.

Kafedra obshcheĭ khirurgii lechebnogo fakul'teta GOU VPO RGMU Roszdrava, Moskva

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