Abstract

In patients suffering from venous thromboembolism, the subsequent anticoagulation treatment significantly reduces the risk of recurrence of further thromboembolic events. However, all available treatment options put the patients at risk of potential life-threatening bleeding complications. Consequently, during the 56th Annual Meeting 2014 of the American Society of Hematology in San Francisco researchers focused on optimizing the use of the current available anticoagulants. Therefore, in the Choosing Wisely® campaign the expert committee recommended to treat patients suffering from their first venous thromboembolism in the setting of major transient risk factors for (not longer than) 3 months. In addition, a French national multicenter trial showed that—if indefinite anticoagulation is not indicated—extended treatment after spontaneous thromboembolism does not reduce the risk of recurrence after stopping the anticoagulation therapy. In patients with cancer-associated thromboembolism, a multicenter study demonstrated the superiority of low molecular heparins over vitamin K antagonist. Finally, a novel, promising target for dissecting hemostasis and antithrombotic effects might be the plasma contact system. Downregulation of factor XI levels in patients undergoing elective knee arthroplasty was an effective method for prevention of postoperative venous thrombosis without increasing the risk of bleeding.

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