Asymptomatic “breakthrough” thrombosis and anticoagulant “failure”: Keep calm and carry on
Abstract Despite therapeutic anticoagulation, patients with venous thromboembolism (VTE) not uncommonly present with findings of progressive thrombosis, sometimes within the first several weeks of treatment. While the prevailing strategy in these scenarios is to assume the current anticoagulant is i...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2019-07-01
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| Series: | Research and Practice in Thrombosis and Haemostasis |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/rth2.12218 |
| _version_ | 1827885811724451840 |
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| author | Sven R. Olson Joseph J. Shatzel Thomas G. DeLoughery |
| author_facet | Sven R. Olson Joseph J. Shatzel Thomas G. DeLoughery |
| author_sort | Sven R. Olson |
| collection | DOAJ |
| description | Abstract Despite therapeutic anticoagulation, patients with venous thromboembolism (VTE) not uncommonly present with findings of progressive thrombosis, sometimes within the first several weeks of treatment. While the prevailing strategy in these scenarios is to assume the current anticoagulant is ineffective and to switch to a different drug class, this practice may be unnecessary. Numerous trials of heparins and vitamin K antagonists for VTE have demonstrated that asymptomatic thrombus propagation despite therapeutic anticoagulation is common. While similar, serial imaging studies after initial VTE have not been replicated in trials of the direct oral anticoagulants, we reason that asymptomatic thrombus propagation detected within the first month of VTE diagnosis can be managed with continuation of the current anticoagulant strategy and close follow‐up for worsening or recurrent symptoms. |
| first_indexed | 2024-03-12T19:52:07Z |
| format | Article |
| id | doaj.art-83352642b4a84411b70b1b5cd90df611 |
| institution | Directory Open Access Journal |
| issn | 2475-0379 |
| language | English |
| last_indexed | 2024-03-12T19:52:07Z |
| publishDate | 2019-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Research and Practice in Thrombosis and Haemostasis |
| spelling | doaj.art-83352642b4a84411b70b1b5cd90df6112023-08-02T03:06:15ZengElsevierResearch and Practice in Thrombosis and Haemostasis2475-03792019-07-013349850210.1002/rth2.12218Asymptomatic “breakthrough” thrombosis and anticoagulant “failure”: Keep calm and carry onSven R. Olson0Joseph J. Shatzel1Thomas G. DeLoughery2Division of Hematology and Medical Oncology Oregon Health and Science University Knight Cancer Institute Portland OregonDivision of Hematology and Medical Oncology Oregon Health and Science University Knight Cancer Institute Portland OregonDivision of Hematology and Medical Oncology Oregon Health and Science University Knight Cancer Institute Portland OregonAbstract Despite therapeutic anticoagulation, patients with venous thromboembolism (VTE) not uncommonly present with findings of progressive thrombosis, sometimes within the first several weeks of treatment. While the prevailing strategy in these scenarios is to assume the current anticoagulant is ineffective and to switch to a different drug class, this practice may be unnecessary. Numerous trials of heparins and vitamin K antagonists for VTE have demonstrated that asymptomatic thrombus propagation despite therapeutic anticoagulation is common. While similar, serial imaging studies after initial VTE have not been replicated in trials of the direct oral anticoagulants, we reason that asymptomatic thrombus propagation detected within the first month of VTE diagnosis can be managed with continuation of the current anticoagulant strategy and close follow‐up for worsening or recurrent symptoms.https://doi.org/10.1002/rth2.12218anticoagulantheparinpostthrombotic syndromethrombosisvenous thromboembolism |
| spellingShingle | Sven R. Olson Joseph J. Shatzel Thomas G. DeLoughery Asymptomatic “breakthrough” thrombosis and anticoagulant “failure”: Keep calm and carry on Research and Practice in Thrombosis and Haemostasis anticoagulant heparin postthrombotic syndrome thrombosis venous thromboembolism |
| title | Asymptomatic “breakthrough” thrombosis and anticoagulant “failure”: Keep calm and carry on |
| title_full | Asymptomatic “breakthrough” thrombosis and anticoagulant “failure”: Keep calm and carry on |
| title_fullStr | Asymptomatic “breakthrough” thrombosis and anticoagulant “failure”: Keep calm and carry on |
| title_full_unstemmed | Asymptomatic “breakthrough” thrombosis and anticoagulant “failure”: Keep calm and carry on |
| title_short | Asymptomatic “breakthrough” thrombosis and anticoagulant “failure”: Keep calm and carry on |
| title_sort | asymptomatic breakthrough thrombosis and anticoagulant failure keep calm and carry on |
| topic | anticoagulant heparin postthrombotic syndrome thrombosis venous thromboembolism |
| url | https://doi.org/10.1002/rth2.12218 |
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