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General practice Terapia 2018, 3 ( 362 ) :  72  -  80

Treatment of venous thromboembolism based on the recommendations of the 2017 Polish Consensus Statement. Analysis of net clinical benefit in extended prophylaxis

Summary: For VTE and no cancer, as long-term anticoagulant therapy, the authors recommend apixaban, edoxaban, rivaroxaban and dabigatran over vitamin K antagonists (VKA). For VTE and cancer, the authors recommend low molecular weight heparins (LMWH) over VKA, apixaban, edoxaban, rivaroxaban and dabigatran. For extended prophylaxis of deep venous thrombosis (DVT), apixaban, edoxaban, rivaroxaban, dabigatran, VKA and sulodexide are recommended. For extended prophylaxis of pulmonary embolism (PE), the paper recommends apixaban, edoxaban, rivaroxaban, dabigatran and VKA. In extended prophylaxis, for patients with idiopathic DVT and a high risk of bleeding complications, the authors recommend NOT stopping anticoagulation and use of sulodexide. In extended prophylaxis, for patients with idiopathic PE and a high risk of bleeding, the authors recommend NOT stopping anticoagulation and suggest treatment with apixaban, edoxaban, rivaroxaban and dabigatran in reduced doses – adjusted to the risk of bleeding. For VTE treated with anticoagulants, they recommend against insertion of vena cava filters. For patients with DVT, the authors suggest USING compression stockings routinely to prevent post-thrombotic syndrome. For sub-segmental PE and no proximal DVT, they suggest clinical surveillance over anticoagulation with a low risk of recurrent VTE, and anticoagulation over clinical surveillance with a high risk. For recurrent VTE on a non-LMWH anticoagulant, they suggest LMWH, and for recurrent DVT and/or PE on LMWH, the authors suggest increasing the LMWH dose.
Keywords: deep vein thrombosis, pulmonary embolism, treatment.

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