Venous thromboembolism: anticoagulation, lysis, or filter?
Experience and review of the literature suggest that when deep venous thrombosis does occur, standard anticoagulation with heparin followed by Coumadin is the mainstay of treatment for both deep venous thrombosis and pulmonary emboli. However, thrombolytic therapy with urokinase or streptokinase may benefit selected patients. Percutaneous caval interruption is the optimal technique to prevent pulmonary embolization, but should be reserved for patients who have contraindications to anticoagulation therapy or recurrent emboli despite adequate anticoagulation. Selected high risk patients may also be candidates for caval interruption.
Robison
J G
JG
Department of Surgery, Medical University of South Carolina, Charleston 29425.
Elliott
B M
BM
D000925:Anticoagulants / Q000627:therapeutic use*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D011655:Pulmonary Embolism / Q000188:drug therapy* / Q000628:therapy; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000188:drug therapy* / Q000628:therapy; D016306:Vena Cava Filters
D000925:Anticoagulants; D005343:Fibrinolytic Agents