Abstract
Objectives: To review the current knowledge regarding the mechanisms of action and the clinical indications of Sulodexide, a glycosaminoglycan with established efcacy for the prevention of recurrent venous thromboembolism, with reduced bleeding risk. A critical review of the Methods: literature regarding Sulodexide in several data sources between 1975 and 2020. A total of 481 articles were found and analyzed but only 21 articles were considered for this review. Antithrombotic effects of Sulodexide include vas Results: cular endothelial protection, diminished platelet aggregation in response to several stimuli, inhibition of plasma coagulation factors Xa and thrombin, enhancement of brinolysis secondary to reducing PAI-1 and increasing of tPA, and decreased blood viscosity. Compared with other extended treatments, Sulodexide decreases mortality and bleeding episodes. Due to its broad range of pleiotropic effects and mainly a Conclusions: ntithrombotic, Sulodexide has emerged as a therapeutic option for the prevention of recurrent venous thromboembolism in subjects with high risk of bleeding, including elderly patients.
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