What is the correct duration of therapy for patients with VTE (deep vein thrombosis) and is there a role for ultrasound to guide management?
The optimal duration of warfarin for first DVT is hotly debated. The important PREVENT trial1 showed that low-intensity warfarin therapy given to patients with VTE (initiated after 6.5 months of full-dose warfarin therapy) reduced the risk of VTE recurrence by 64% over a mean period of 2 years. The multi-center AESOPUS trial2 asked whether ultrasonographic (USG) detection of residual thrombi could be used to guide the duration of anticoagulation and reduce the rate of VTE recurrence. Patients who experienced a first DVT were treated with 3 months of oral anticoagulant. Patients who completed this period without an event were randomized to fixed-duration or flexible-duration warfarin treatment. The fixed-group individuals with secondary DVT received 3 months of warfarin, and those with unprovoked DVT received 6 months of therapy. The flexible-duration group’s therapy was terminated at 3 months if their USG showed vein re-canalization. Patients whose veins had not re-canalized at 3 month
Related Questions
- What is the correct duration of therapy for patients with VTE (deep vein thrombosis) and is there a role for ultrasound to guide management?
- Should All Patients Undergo Postoperative Duplex Imaging to Detect a Deep Vein Thrombosis After Varicose Vein Surgery?
- Should Every Patient with Deep Vein Thrombosis Be Examined using Thoracic Ultrasound?
