0
Sign In  | Subscribe
5 May 2009, Vol 150, No. 9>
Summaries for Patients | 5 May 2009

Residual Thrombosis to Guide the Duration of Anticoagulation FREE

[+] Article and Author Information

The summary below is from the full report titled “Residual Thrombosis on Ultrasonography to Guide the Duration of Anticoagulation in Patients With Deep Venous Thrombosis. A Randomized Trial.” It is in the 5 May 2009 issue of Annals of Internal Medicine (volume 150, pages 577-585). The authors are P. Prandoni, M.H. Prins, A.W.A. Lensing, A. Ghirarduzzi, W. Ageno, D. Imberti, G. Scannapieco, G.B. Ambrosio, R. Pesavento, S. Cuppini, R. Quintavalla, and G. Agnelli, for the AESOPUS Investigators.


Ann Intern Med. 2009;150(9):I-44. doi:10.7326/0003-4819-150-9-200905050-00001
Text Size: A A A

What is the problem and what is known about it so far?

Deep venous thrombosis (DVT) occurs when blood clots form in the large leg veins. Pieces of these clots can break off and travel to the lungs and cause serious illness or death. Physicians use blood thinners (anticoagulants) to help dissolve the clots and prevent more clots from forming. The optimal duration of anticoagulant therapy for DVT is unclear.

Why did the researchers do this particular study?

To see which of 2 strategies better prevents recurrent clots over the long term in adults with DVT.

Who was studied?

538 patients who had already completed 3 months of anticoagulant therapy for DVT.

How was the study done?

The researchers randomly assigned patients to a fixed- or flexible-duration, ultrasonography-guided treatment strategy. Depending on the underlying cause of the DVT, patients in the fixed-duration group received either no additional treatment or 3 more months of anticoagulation (warfarin). Patients in the flexible-duration group had no further treatment if ultrasonography showed dissolved leg clots (recanalized veins) and continued anticoagulation with warfarin for 9 to 21 months if repeated ultrasonography showed persistent clots (residual thrombosis). The researchers followed patients for 33 months to assess recurrent clots and bleeding complications.

What did the researchers find?

More patients assigned to the fixed-duration group than the flexible-duration group had recurrent clots (17% vs. 12%). Slightly fewer patients assigned to the fixed-duration group had major bleeding complications (0.7% vs. 1.5%).

What were the limitations of the study?

There may have been too few participants to detect potentially important differences between groups in bleeding complications. The findings may not apply to patients with a history of several episodes of DVT or permanent risk factors for DVT because these patients were not studied.

What are the implications of the study?

Ultrasonography findings could help guide further treatment duration in patients who have already received anticoagulation for DVT for 3 months.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general jounals
BMJ 2010;341:c5893-c1494.

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Want to Subscribe?

Learn more about subscription options

Register Now for a free account
Advertisement

Related Content

Customize your page view by dragging & repositioning the boxes below.

Topic Collections
PubMed Articles
[Regarding: Benefit/risk ratio analysis from a possible anticoagulation of asymptomatic deep venous thrombosis in major orthopedic surgery.]
Journal des maladies vasculaires Issue date: 2013 May 31
High incidence of heparin-induced allergic delayed-type hypersensitivity reactions in pregnancy.
The Journal of allergy and clinical immunology Issue date: 2013 May 29

Annals of Internal Medicine

Other Resources

Copyright © 2013 The American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Want to Subscribe?

Learn more about subscription options

Register Now for a free account
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)