Prevention Of Deep Venous Thrombosis Research Articles

PENGGUNANAAN COMPRESSION STOCKING TERHADAP PENCEGAHAN DEEP VENOUS THROMBOSIS (DVT): LITERATUR REVIEW

Deep Venous Thrombosis (DVT) is a condition in which a clot forms in vein due to inflammation/ venous wall trauma or due to partial venous obstruction. Most DVT comes from lower extremities. Pulmonary embolism is a significant risk for DVT because the release of thrombus then follows the blood flow and is trapped in the pulmonary artery. Compression is one of the therapies that helps prevent blood clots that form in the foot by applying pressure varies on each part of the foot. The purpose of this review literature is to determine the effectiveness of using the Compression for prevention of DVT. The process of searching journal articles uses Google Scholar and several databases, namely Cocrane, Proques and Pubmed. Keywords included are compression therapy, compression stocking and deep venous thrombosis. Search results in each database based on keywords by reading the research abstract obtained 7 journal articles. The use of Compression for prevention of DVT has been proven by several studies. This is because works by exerting a level on the ankle with a gradual level. A pressure gradient or will ensure that blood flows towards the heart instead of reflux to the foot. But in the use of Compression in the prevention of DVT, patients need to obtain information specifically about how to use it to avoid complications that might arise due to the use of Compression .

Investigation on the self-efficacy and the knowledge, attitude, behaviour of obstetric nurses in prevention of deep venous thrombosis

Investigation on the self-efficacy and the knowledge, attitude, behaviour of obstetric nurses in prevention of deep venous thrombosis

Formulation and application of prevention and control guideline for deep venous thrombosis in lower extremities bedridden elderly patients

Objective To formulate a prevention and control guideline for deep venous thrombosis (DVT) in lower extremities in bedridden elderly patients and to explore its effects. Methods The problems existing in prevention and control of DVT in bedridden elderly patients were analyzed by search for literature, interviewing medical and nursing staff in the ward and reviewing DVT cases in bedridden elderly patients. The prevention and control guideline was formulated based on the evidence-based practice guideline. Relevant health videos were made and quality control measures were formulated by building DVT prevention and control teams and processes for bedridden elderly patients and adopting Caprini's and Padua's risk assessment tools. The prevention and control guideline was put into clinical use since February 2017. The incidence of DVT and blood stasis in bedridden elderly patients before (from May 2016 to January 2017, n=112) and after (between February and November 2017, n=99) the implementation of the guideline. Results After the prevention and control guideline was implemented, the positive rate of blood stasis in the bedridden elderly patients rose from 6.3% (7/112) to 15.2% (15/99) , while the incidence rate of DVT dropped from 8.9% (10/112) to 2.0% (2/99) (χ2=4.458, 4.676; P<0.05) . Conclusions The prevention and control guideline based on the DVT prevention and management guideline can reduce the risks of DVT in bedridden elderly inpatients. Key words: Aged; Deep venous thrombosis; Bedridden patients; Prevention

Effect of a new inhibitor of factor Xa zifaxaban, on thrombosis in the inferior vena cava in rabbits.

In recent years, oral factor Xa inhibitors have become a research focus as anticoagulant drugs. Zifaxaban is the first oral FXa inhibitor to enter clinical trials in China. The aim of this study was to determine the inhibitory effect of zifaxaban on thrombosisthrough a model ofinferior vena cava (IVC) thrombosis in rabbits. IVC thrombosis model was established by electrical injury and stenosis, and zifaxaban was administered (p.o.) for 5 consecutive days, then coagulation indicators and bleeding were observed. The results showed that zifaxaban had obvious inhibitory effects on FXa, and had a significant inhibitory effect on IVC thrombosis induced by electrical damage and stenosis. The effect of zifaxaban was similar to that of rivaroxaban, but the bleeding side-effects of zifaxaban were less severe than those of rivaroxaban. Zifaxaban could prolong the prothrombin time and activated partial thromboplastin time of plasma similar to that of other oral FXa inhibitors. Zifaxaban had a significant inhibitory effect on FXa, but it had no obvious effect on other coagulation factors, major anticoagulant factors or fibrinolytic indices. Our results suggest that zifaxaban had specific inhibitory effects on FXa and inhibited IVC thrombosis in rabbits with its hemorrhagic effect was less than that of rivaroxaban. Zifaxaban is ecpected to be developed as a new drug for the prevention of deep venous thrombosis, providing more medication options for patients with such disease, more research is required to support it in the future.

Oral Xa Inhibitors Versus Low Molecular Weight Heparin for Thromboprophylaxis After Nonoperative Spine Trauma

BackgroundThromboprophylaxis with oral Xa inhibitors (Xa-Inh) are recommended after major orthopedic operation; however, its role in spine trauma is not well-defined. The aim of our study was to assess the impact of Xa-Inh in spinal trauma patients managed nonoperatively. MethodsA 4-y (2013-2016) review of the Trauma Quality Improvement Program database. We included all patients with an isolated spine trauma (Spine-abbreviated injury scale ≥3 and other-abbreviated injury scale <3) who were managed nonoperatively and received thromboprophylaxis with either low molecular weight heparin (LMWH) or Xa-Inh. Patients were divided into two groups based on the thromboprophylactic agent received: Xa-Inh and LMWH and were matched in a 1:2 ratio using propensity score matching for demographics, vitals and injury parameters, and level of spine injury. Outcomes were rates of deep venous thrombosis, pulmonary embolism, and mortality. ResultsWe analyzed a total of 58,936 patients, of which 1056 patients (LMWH: 704, Xa-Inh: 352) were matched. Matched groups were similar in demographics, vital and injury parameters, length of hospital stay (P = 0.31), or time to thromboprophylaxis (P = 0.79). Patients who received Xa-Inh were less likely to develop a deep venous thrombosis (2.3% versus 5.7%, P < 0.01). There were no differences in the rate of pulmonary embolism (P = 0.73), postprophylaxis packed red blood cells transfusions (P = 0.79), postprophylaxis surgical decompression of spinal column (P = 0.75), and mortality rate (P = 0.77). ConclusionsOral Xa-Inh seems to be more effective as prophylactic pharmacologic agent for the prevention of deep venous thrombosis in patients with nonoperative spinal trauma compared to LMWH. The two drugs had similar safety profile. Further prospective trials should be performed to change current guidelines.

Efficacy and safety of low-molecular-weight heparin after knee arthroscopy: A meta-analysis.

BackgroundVenous thromboembolism (VTE) is considered a potentially serious complication of knee arthroscopy and leads to conditions such as deep venous thrombosis (DVT) and pulmonary embolism (PE). Low-molecular-weight heparin (LMWH) is widely employed in knee arthroscopy to reduce perioperative thromboembolic complications. However, the efficacy and safety of LMWH in knee arthroscopy remains unclear.MethodsSeven randomized controlled clinical trials on LMWH in knee arthroscopy were identified and included in this meta-analysis. The main outcomes of the effectiveness (prevention of DVT and PE) and complications (death, major bleeding, and minor bleeding) of LMWH in knee arthroscopic surgery were assessed using Review Manager 5.3 software.ResultsThe meta-analysis indicated that LMWH prophylaxis comprised 79% of asymptomatic DVT. No association was found in symptomatic VTE (RR: 0.90; 95% confidence interval [CI]: 0.39–2.08; P = 0.80), symptomatic DVT (RR: 0.79; 95% CI: 0.28–2.23; P = 0.66), symptomatic PE (RR: 1.36; 95% CI: 0.37–4.97; P = 0.64) and major bleeding (RR: 0.70; 95% CI: 0.12–3.95; P = 0.68) risk during LMWH prophylaxis were identified. Death was not reported in these studies. Moreover, there was a lower incidence of minor bleeding (RR: 0.64; 95% CI: 0.49 to 0.83; P = 0.001) in the control group than in the LMWH group.ConclusionCompared with the control group, the group treated with LMWH after knee arthroscopy was no association in reducing the symptomatic VTE rate, symptomatic DVT rate or symptomatic PE rate. The symptomatic VTE rate was 0.5% (11/2,166) in the LMWH group versus 0.6% (10/1,713) in the control group. Although the limitations of this meta-analysis cannot be ignored, the results of our study show that LMWH after knee arthroscopy is ineffective. We recommend that LMWH should not be routinely provided for knee arthroscopy.Trial registrationClinicalTrials.gov NCT03164746

Effects of Natural Hirudin and Low Molecular Weight Heparin in Preventing Deep Venous Thrombosis in Aged Patients with Intertrochanteric Fracture

Our objective was to evaluate the efficacy and safety of natural hirudin and low molecular weight heparin (LMWH) in the prevention of perioperative deep venous thrombosis (DVT) in elderly patients with intertrochanteric fracture. From June 2014 to June 2017, 96 patients with intertrochanteric fractures were treated with proximal femoral nail antirotation (PFNA) were randomly divided into two groups. For DVT prevention, 45 patients were treated with oral natural hirudin and subcutaneous LMWH-calcium (test group) and 51 patients were treated with subcutaneous LMWH-calcium (control group). The mean intraoperative bleeding, wound drainage and incisional hematoma were higher in the test group, with no significant differences between the groups. There were significant differences in distal intramuscular venous thrombosis (P = 0.043). Both activated partial thromboplastin time (APTT), thrombin time (TT), and prothrombin time (PT) lengthened in both groups postoperatively, and there was a significant difference between the two groups two weeks postoperatively. D-dimer were significantly different and platelet count (PLT) did not differ between groups two weeks postoperatively. In elderly patients with unilateral intertrochanteric fracture after PFNA on anticoagulant therapy, the combination of natural hirudin and LMWH was more effective than that of LMWH-calcium alone, with no significant difference with regard to safety.

Novel Oral Anticoagulants, A Subject in Continuing Debate

Abstract Coumarin anticoagulants era (warfarin, acenocumarol) seems to be coming to an end with the launch of the novel anticoagulants like dabigatran, rivaroxaban, apixaban and edoxaban. Dabigatran (Pradaxa) is a prothrombin (factor II) inhibitor that doesn't necessitate monitoring by coagulation tests, doesn't have food or drug interactions, except for P-gp inhibitors. Rivaroxaban (Xarelto) is a direct inhibitor of factor X and is approved for the prevention of thromboembolic events in patients with non-valvular atrial fibrillation and for the prevention of deep venous thrombosis in patients undergoing orthopaedic surgery (hip and knee prosthesis). Apixaban (Eliquis) is a direct inhibitor of factor X and is indicated for the prevention of venous thromboembolic events in patients undergoing hip or knee arthroplasty, the prevention of thromboembolic events in patients with non-valvular atrial fibrillation and treatment or prevention of recurrences in patients with deep vein thrombosis or pulmonary embolism. Edoxaban (Savaysa), recently approved is USA, is a direct inhibitor of factor X and is indicated for deep venous thrombosis, pulmonary embolism and for the prevention of thromboembolic events in patients with non-valvular atrial fibrillation. The most recent studies focus on antidotes specifically designed to bind and neutralise the anticoagulant activity of both direct thrombin inhibitors and direct factor Xa inhibitors. The drugs currently being studied are idarucizumab, a specific antidote, andexanet alfa, a class-specific antidote and ciraparantag, a universal antidote. Of these, only idarucizumab was approved by the FDA.

Traditional Chinese and western medicine for the prevention of deep venous thrombosis after lower extremity orthopedic surgery: a meta-analysis of randomized controlled trials

BackgroundChinese herbal medicine has traditionally been considered to promote blood circulation to remove obstruction in the channels and clear pathogenic heat to drain dampness effects. We conducted this meta-analysis to evaluate its benefits for the prevention of deep venous thrombosis (DVT) after lower extremity orthopedic surgery.MethodsRelevant, published studies were identified using the following keywords: lower extremity orthopedic surgery, arthroplasty, joint replacement, fracture, traditional Chinese and western medicine, Chinese herbal medicine, deep venous thrombosis (DVT), and Venous thromboembolism (VTE). The following databases were used to identify the literature consisting of RCTs with a date of search of 31 May 2017: PubMed, Cochrane Library, Web of knowledge, the Chinese National Knowledge Infrastructure Database, the Chongqing VIP Database, the Chinese Biomedical Database, and the Wanfang Database (including three English and four Chinese databases). All relevant data were collected from studies meeting the inclusion criteria. The outcome variables were the incidence rate of DVT, activated partial thromboplastin time (APTT), prothrombin time (PT), and d-dimer; subcutaneous hematoma; and other reported outcomes. RevMan5.2. software was adopted for the meta-analysis.ResultsA total of 20 published studies (1862 cases) met the inclusion criteria. The experimental group, 910 patients (48.87%), received the Chinese herbal medicine or traditional Chinese and western medicine for prevention of DVT; the control group, 952 patients (51.13%), received the standard western treatment. The meta-analysis showed that traditional Chinese and western medicine therapy reduced the incidence rates of DVT significantly when compared with controls (risk ratio [RR] = 0.40; 95% CI, 0.30 to 0.54; P < 0.00001), and the d-dimer was lower in the experimental group (P = 0.01). Besides, the incidence rate of subcutaneous hematoma was lower in the experimental group (P < 0.0001). However, no significant difference was found in the PT (P = 0.98) and APTT (P = 0.75) in two groups. No serious adverse events were reported.ConclusionTraditional Chinese and western medicine therapy may be a safe, effective prevention modality for DVT after lower extremity orthopedic surgery. Further rigorously designed, randomized trials are warranted.

Profilaxia da trombose venosa profunda em cirurgia bariátrica: estudo comparativo com doses diferentes de heparina de baixo peso molecular

ResumoContexto A cirurgia bariátrica é considerada a melhor opção para o tratamento da obesidade, cujos pacientes são considerados de alto risco para fenômenos tromboembólicos. Objetivos Comparar o uso de doses diferentes de heparina de baixo peso molecular (HBPM) na profilaxia da trombose venosa profunda (TVP) em pacientes candidatos à cirurgia bariátrica em relação ao risco de TVP, alteração na dosagem do fator anti-Xa e sangramento pré ou pós-operatório. Métodos Estudo comparativo transversal em pacientes submetidos à cirurgia bariátrica distribuídos em dois grupos, que receberam doses de HBPM de 40 mg (grupo controle, GC) e 80 mg (grupo de estudo, GE). Foram avaliados por ultrassonografia vascular e dosagem de KPTT, TAP, plaquetas e fator anti-Xa. Resultados Foram avaliados 60 pacientes, sendo 34 no GC e 26 no GE. Foi observada diferença significativa somente no peso (p = 0,003) e índice de massa corporal (p = 0,018) no GE em relação ao GC. Não houve diferença na dosagem de KPTT, TAP, plaquetas e fator anti-Xa entre os grupos. Não foram detectados TVP ou sangramentos significativos em ambos os grupos. Conclusões Não houve diferença estatisticamente significativa na utilização de doses maiores de HBPM na profilaxia da TVP em pacientes candidatos à cirurgia bariátrica em relação ao risco de TVP, dosagem do fator anti-Xa e sangramento pré ou pós-operatório.

Pilot study evaluating the efficacy of exergaming for the prevention of deep venous thrombosis.

Current prophylactic protocols fail to prevent deep venous thrombosis (DVT) in a significant minority of patients, and it remains one of the leading causes of preventable death. We therefore quantified the efficacy of novel game-based exercises (exergaming) to augment femoral venous parameters relative to ankle movement and muscle flexion. Healthy volunteers were recruited to perform a series of ankle and foot exercises using a wireless foot sensor (LEGSys; BioSensics LLC, Watertown, Mass) to navigate a computer cursor sequentially on a screen to the center of 200 circular targets. A single ultrasound technician (W.A.M.) measured each patient's mean flow volume, peak flow velocity, mean flow velocity, and cross-sectional area of the right femoral vein at baseline and obtained immediate postexercise (PEX), 5-minute PEX, and 15-minute PEX measurements. Electromyography (EMG) was performed at baseline and during the exercise. Baseline demographics and medical and surgical comorbidities were also recorded. The primary end point was the difference between baseline and immediate PEX mean flow volume estimates. We secondarily explored the association of baseline characteristics and EMG measurements with femoral vein parameters. Fifteen healthy subjects (53% male; 28.1± 4.6years) completed the exergaming task within a mean of 4minutes, 2± 21seconds. Immediately after exercise, the femoral vein mean flow volume, mean velocity, and peak systolic velocity increased by 49%, 53%, and 48%, respectively (P< .02 for each). Mean flow volume and velocity remained significantly elevated 5minutes after exercise (P< .04 for each). Plantar flexion and dorsiflexion velocities and EMG frequency and intensity were not significantly correlated with PEX mean flow volume estimates (P > .05). Subgroup analysis revealed that women (P< .01) and Hispanics (P< .01) exhibited significantly slower PEX responses. Subjects with the largest improvements in mean flow volume had lower peak plantar flexion velocities (P< .01). Exergaming increases mean flow volume, mean flow velocity, and peak systolic velocity within the femoral vein by approximately 50% above baseline. Exergaming represents a novel and potentially attractive method of DVT prevention by augmenting femoral vein mean volume flow and capitalizing on biofeedback. Less forceful but more uniform contractions were found to be most effective at augmenting venous blood flow. Exergaming will require further validation in larger study bases, among patients at higher risk of DVT.

Chemical venous thromboembolism prophylaxis in neurosurgical patients: an updated systematic review and meta-analysis.

Venous thromboembolism (VTE) is a common and potentially life-threatening complication. The risk of serious hemorrhagic complications when starting chemical prophylaxis for VTE prevention is a substantial concern for neurosurgeons. The objective of this study was to perform an updated systematic review and meta-analysis to determine if the rates of VTE and bleeding complications are different in patients undergoing chemoprophylaxis compared with placebo or mechanical prophylaxis alone following cranial or spinal procedures. In February 2016 a systematic literature review was performed identifying 3944 articles from 4 different databases. A random-effects meta-analysis was performed after identifying the articles that met inclusion criteria. Nine articles that met the inclusion criteria were included. The quality of the studies was good, with all of them being classified as Level 2 evidence, with moderate Jadad scores. A meta-analysis comparing chemoprophylaxis with placebo in the prevention of deep venous thrombosis showed a significant benefit to chemical prophylaxis (OR 0.51, 95% CI 0.37-0.71; p < 0.0001). No significant increase in major intracranial hemorrhage (p = 0.60), major extracranial hemorrhage (p = 0.98), or minor bleeding complications (p = 0.60) was found. Based on moderate-to-good quality of evidence, chemoprophylaxis is beneficial in preventing VTE, with no significant increase in either major or minor bleeding complications in patients undergoing cranial and spinal procedures. Further research is needed to determine whether this conclusion holds true for more specific subpopulations.

Chinese expert consensus of prevention of deep venous thrombosis and pulmonary embolism after gynecologic surgery

Chinese expert consensus of prevention of deep venous thrombosis and pulmonary embolism after gynecologic surgery

Is deep venous thrombosis a common complication in patients treated with Ilizarov external fixator?

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Determining the incidence of deep venous thrombosis (DVT), a prospective study, in patients treated with Ilizarov external fixators for lower extremity fractures, fracture non unions or deformity correction.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A Prospective, observational and cross sectional study. 49 Patients with complex lower extremity injuries, deformities and non-union of fractures were treated with Ilizarov external fixator application, were assessed clinically and radiological (Venous Doppler) at regular intervals- 6 days post-surgery then at 6 weeks, 12 weeks and between 4 to 6 months post-operative. None were given chemoprophylaxis for the prevention of DVT and everyone were assessed pre operatively with a questionnaire and wells criteria was taken for assessment of high risk for developing venous thrombosis. There were 41 men and 8 women, 85.75% of the study group is of age 30 to 60 years.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Only 1 of 49 patients developed radiological evident DVT within 6 days of surgery. Patients who underwent application of Ilizarov external fixator electively for deformity correction, osteomyelitis and non-union showed no clinical or radiological evident signs of DVT.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The incidence of DVT and PTE is minimal when patients without chemoprophylaxis underwent lower limb Ilizarov external fixator application for acute trauma and electively for deformity correction, treatment of non-union and osteomyelitis. However further comparative and randomized studies need to be done to confirm our results.&lt;/p&gt;

GW28-e0096 The efficacy of rivaroxaban combined with aspirin on prevention of deep venous thrombosis in elderly patients with hip fracture

GW28-e0096 The efficacy of rivaroxaban combined with aspirin on prevention of deep venous thrombosis in elderly patients with hip fracture

Application of strengthening physical intervention in prevention of deep venous thrombosis after knee arthroplasty for severe hemophilic arthritis

Objective To explore the effects of strengthening physical intervention in prevention of deep venous thrombosis (DVT) after knee arthroplasty for severe hemophilic arthritis. Methods A total of 15 hemophiliacs with knee arthroplasty received perioperative nursing care from January 2014 to January 2016. The nursing care was centered on strengthening physical intervention and was assisted by early activities along with pertinently observing complications. The occurrence of DVT and related complications were all observed. Results There were no patient with DVT and complications related to physical prevention among 15 patients after surgeries. Conclusions Nursing intervention centered on strengthening physical intervention and assisted by early activities can effectively prevent DVT in hemophiliacs after knee arthroplasty and make patients safe during perioperative phase. Key words: Arthroplasty, replacement, knee; Deep vein thrombosis; Hemophilic arthritis; Prevention; Strengthening physical intervention

Pilot Study Evaluating the Efficacy of Exergaming for the Prevention of Deep Venous Thrombosis

Pilot Study Evaluating the Efficacy of Exergaming for the Prevention of Deep Venous Thrombosis

Effects of predictive phased intervention on preventing lower extremity deep venous thrombosis in ICU patients

Objective To evaluate the preventive effects of predictive phased intervention on lower extremity deep vein thrombosis in ICU patients. Methods A total of 82 cases of critically ill patients admitted to our hospital from June 2013 to June 2016 were divided into observation group and control group according to the random number table method, with 41 cases respectively. Patients in the observation group received predictive phased intervention, while patients in the control group received routine nursing intervention. After 4 weeks of intervention, the lower extremity deep venous thrombosis rate, lower limb perimeter and blood flow velocity of lower extremity venous were compared between two groups. Results The incidence of lower extremity deep venous thrombosis was 2.44% in the observation group and 19.51% in the control group. The difference between two groups was statistically significant (χ2=6.604, P<0.05) . After the intervention, the lower limb perimeter of patients in the observation group was (30.01±2.34) cm, which was significantly lower than that of the control group; the venous blood flow velocity of the lower extremity of patients in the observation group was (25.43±3.01) cm/s, which was significantly higher than that of the control group (t=2.285, 2.357; P<0.05) . Conclusions Predictive phased intervention has obvious advantages in the prevention of lower extremity deep venous thrombosis in ICU patients and it is worth clinical promotion. Key words: Venous thrombosis; Intensive care units; Predictive phased intervention; Lower limb perimeter

Venous thromboembolism — recommendations on the prevention, diagnostic approach and management. The 2017 Polish Consensus Statement

The 2017 Polish Consensus Statement (PCS 2017) includes updated recommendations on the prevention, diagnostic approach, and management of venous thromboembolism (VTE). For VTE without cancer, the authors of PCS 2017 recommend apixaban, edoxaban, rivaroxaban, and dabigatran over vitamin K antagonists (VKA) as long-term anticoagulant therapy. For VTE with cancer, the authors of PCS 2017 recommend low molecular weight heparins (LMWH) over VKA, apixaban, edoxaban, rivaroxaban and dabigatran. For extended secondary prevention of deep venous thrombosis (DVT), PCS 2017 recommends apixaban, edoxaban, rivaroxaban, dabigatran, VKA, and sulodexide. For extended secondary prevention of pulmonary embolism (PE), PCS 2017 recommends apixaban, edoxaban, rivaroxaban, dabigatran and VKA. For extended secondary prevention in patients with idiopathic DVT and a high risk of bleeding complications, the authors of PCS 2017 recommend NOT to stop anticoagulation and use sulodexide. For extended secondary prevention in patients with idiopathic PE and a high risk of bleeding, the authors of PCS 2017 recommend NOT to stop anticoagulation and suggest treatment with apixaban, edoxaban, rivaroxaban, and dabigatran in reduced doses adjusted to the risk of bleeding. For VTE treated with anticoagulants, PCS 2017 recommends against insertion of a vena cava filter. For patients with DVT, PCS 2017 suggests USING compression stockings routinely to prevent postthrombotic syndrome. For subsegmental PE without proximal DVT, PCS 2017 suggests clinical surveillance over anticoagulation with a low risk of recurrent VTE, and anticoagulation over clinical surveillance with a high risk of recurrent VTE. The 2017 Polish Consensus Statement suggests thrombolytic therapy for PE with hypotension, and systemic therapy over catheter-directed thrombolysis. For recurrent VTE on a non-LMWH anticoagulant, PCS 2017 suggests LMWH, and for recurrent DVT and/or PE on LMWH, PCS 2017 suggests increasing the dose of LMWH.

Anti-inflammatory effects of simvastatin during the resolution phase of experimentally formed venous thrombi

Deep venous thrombosis (DVT) is a common vascular disease and is closely linked to inflammation. Over the past decade, the potential antithrombotic effect of statins has been elucidated by clinical...