Journal of thrombosis and thrombolysis
-
J. Thromb. Thrombolysis · Feb 2008
ReviewTreatment of DVT: how long is enough and how do you predict recurrence.
Currently available anticoagulants are effective in reducing the recurrence rate of venous thromboembolism (VTE). However, anticoagulant treatment is associated with an increased risk for bleeding complications. Thus, anticoagulation has to be discontinued when benefit of treatment no longer clearly outweigh its risks. ⋯ Currently available anticoagulants are effective in reducing the incidence of recurrent venous thromboembolism, but they are associated with an increased risk for bleeding complications. All patients with acute venous thromboembolism should receive oral anticoagulant treatment for three months. At the end of this treatment period physicians should decide for definitive withdrawal or indefinite anticoagulation with scheduled periodic re-assessment of the benefit from extending anticoagulation.
-
J. Thromb. Thrombolysis · Dec 2007
Multicenter StudyCommunity-based treatment of venous thromboembolism with a low-molecular-weight heparin and warfarin.
This multicenter, prospective, open label, observational study evaluated practice patterns of physicians using tinzaparin, a low-molecular-weight heparin (LMWH), and warfarin for the treatment of deep venous thrombosis (DVT) with or without pulmonary embolism (PE). Short-term recurrence of venous thromboembolism (VTE) and safety were also evaluated. Patients with an objective diagnosis of DVT, with or without PE, were invited by their physician to participate in this study. ⋯ Severity of disease was the primary reason for hospitalization. Home treatment of DVT, with or without PE, with self administration of tinzaparin at 175 IU SQ once-daily was safe and resulted in an acceptably low rate of recurrent venous thromboembolism and adverse events. Home therapy in the usual practice setting should achieve substantial overall cost savings in the treatment of DVT.
-
J. Thromb. Thrombolysis · Oct 2007
Modified thrombolysis in myocardial infarction (TIMI) risk score to risk stratify patients in the emergency department with possible acute coronary syndrome.
To assess the prognostic utility of the Thrombolysis in Myocardial Infarction (TIMI) risk score in patients in the emergency department (ED) evaluated for possible acute coronary syndrome (ACS). ⋯ A modified TIMI risk score may simplify risk stratification of ED patients with undifferentiated chest pain.
-
J. Thromb. Thrombolysis · Oct 2007
Low-dose oral vitamin K to normalize the international normalized ratio prior to surgery in patients who require temporary interruption of warfarin.
In patients who require warfarin interruption before surgery and have an elevated international normalized ratio (INR) before surgery, low-dose vitamin K may normalize the INR in time for surgery. ⋯ In patients requiring interruption of warfarin for surgery, 1 mg oral vitamin K on the day before surgery can normalize the INR by the day of surgery and may not confer resistance to warfarin re-anticoagulation after surgery.
-
J. Thromb. Thrombolysis · Apr 2007
Review Case ReportsTenecteplase to treat pulmonary embolism in the emergency department.
Tenecteplase, a mutant form of alteplase, possesses pharmacological properties that might favor its use for emergent fibrinolysis of acute pulmonary embolism. Contemporaneous search of the World's literature reveals 14 humans with acute pulmonary embolism treated with tenecteplase. ⋯ None of our eight patients had a significant hemorrhagic event after tenecteplase, and the outcomes of all eight appear to be acceptable. Taken together, we submit that the present case report and prior case reports are sufficient to comprise a phase I study of the safety and efficacy of tenecteplase to treat acute pulmonary embolism.