PMID- 10493239
OWN - NLM
STAT- MEDLINE
DCOM- 19991105
LR  - 20051116
IS  - 0957-5235 (Print)
IS  - 0957-5235 (Linking)
VI  - 10 Suppl 2
DP  - 1999 Aug
TI  - Customizing our approach in deep vein thrombosis and pulmonary embolism 
      treatment: overview of our clinical experience.
PG  - S107-15
AB  - Until recently, the management of established deep vein thrombosis (DVT) and 
      pulmonary embolism remained largely unchanged and unchallenged. Treatment 
      comprised an initial intravenous bolus of unfractionated heparin (UFH), followed 
      by dose-adjusted intravenous UFH for 5-7 days, and oral warfarin for three 
      months. UFH is traditionally administered in hospital, and monitoring and dose 
      adjustment remain essential features of both UFH and warfarin treatment, making 
      therapy both costly and inconvenient. Recent clinical trials have shown that 
      subcutaneous UFH, or low-molecular-weight heparins (LMWHs), administered 
      subcutaneously at a weight-adjusted fixed dose, are at least as effective as 
      standard UFH given intravenously in the treatment of DVT. The feasibility of 
      initial treatment of DVT at home in selected patients, with associated 
      cost-savings and improved convenience have also been demonstrated with LMWHs. 
      Clinical trials are currently investigating the potential value of LMWHs in the 
      treatment of pulmonary embolism and as an alternative to warfarin in secondary 
      prevention of DVT. The role of newer anticoagulants, such as recombinant hirudin, 
      in initial treatment of DVT, and of thrombolysis in the management of pulmonary 
      embolism remain to be defined.
FAU - Turpie, A G
AU  - Turpie AG
AD  - Faculty of Medicine, McMaster University, Hamilton, Ontario, Canada.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - Blood Coagul Fibrinolysis
JT  - Blood coagulation & fibrinolysis : an international journal in haemostasis and 
      thrombosis
JID - 9102551
SB  - IM
MH  - Disease Management
MH  - Humans
MH  - Pulmonary Embolism/*therapy
MH  - Venous Thrombosis/*therapy
RF  - 60
EDAT- 1999/09/24 00:00
MHDA- 1999/09/24 00:01
CRDT- 1999/09/24 00:00
PHST- 1999/09/24 00:00 [pubmed]
PHST- 1999/09/24 00:01 [medline]
PHST- 1999/09/24 00:00 [entrez]
PST - ppublish
SO  - Blood Coagul Fibrinolysis. 1999 Aug;10 Suppl 2:S107-15.