[Secondary prevention of venous thromboembolism in patients with cancer].
Venous thromboembolism occurs in about 10% of patients with cancer. In this setting, vitamin K antagonists have been associated with a high risk of recurrent disease and major bleeding. Low-molecular-weight heparin allows reducing by 50% the rate of recurrent venous thromboembolism as compared to vitamin K antagonists. Even with low-molecular-weight heparin, recurrent venous thromboembolism occurs in up to 6% of the patients. In this case it has been suggested to increase the dosage of low-molecular-weight heparin. Vena cava filtration probably plays a minor role in setting. After the sixth month, prolongation of low-molecular-weight-heparin or switch to vitamin K antagonist should be discussed on a case by case basis.
Service de pneumologie, soins intensifs, Hôpital européen Georges-Pompidou, AP-HP, 75908 Paris Cedex 15. guy.meyer@egp.aphp.fr
Guy
G
Meyer
D000925:Anticoagulants / Q000627:therapeutic use*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D009369:Neoplasms / Q000150:complications*; D017410:Practice Guidelines as Topic; D055502:Secondary Prevention; D054556:Venous Thromboembolism / Q000150:complications* / Q000517:prevention & control*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight