Risk Factors for Venous Thromboembolism and Duration of Anticoagulation Therapy

Abstract

An adequate regimen for prophylaxis of venous thromboembolism (VTE) requires
indentifi cation of reversible and irreversible risk factors. Recent data confi rm that
the greatest number of pulmonary emboli (PE) occur in non-surgical patients. VTE
also develops in many surgical patients upon hospital discharge. These fi ndings
emphasize the need for adequate VTE prophylaxis in infl ammatory diseases, acute
medical illness, and other conditions, as well as the need to optimize anticoagulant
regimens after surgery. Establishing VTE risk factors, identifying acquired or inherited
thrombophylias and occult or previously undiagnosed malignancy will help design
an adequate anticoagulant regimen as secondary VTE prophylaxis for surgical and
other patients. Follow up measures should include D-dimer values, ultrasonographic
assessment of residual venous thrombosis and echocardiographic parameters,
along with other relevant clinical data to assess the risk of VTE reoccurrence. These
procedures will ensure the optimal duration of individually tailored anticoagulant
therapy, with special attention to comorbidities and tendency to hemorrhage.