Balancing risks and benefits of extended anticoagulant therapy for idiopathic venous thrombosis

Abstract

About half of the patients with a first idiopathic proximal deep vein thrombosis (DVT) or pulmonary embolism (PE) are expected to have a recurrent episode of venous thromboembolism (VTE) within 10 years of stopping therapy, and randomized trials have shown that this group of patients benefit from long-term anticoagulant therapy. High risks for bleeding and patient preference are compelling reasons not to treat such patients long-term. Although a number of factors are associated with a reduced risk of recurrence, they require further validation before it is appropriate to routinely stop anticoagulants after 3months in patients with idiopathic proximal DVT or PE. © 2009 International Society on Thrombosis and Haemostasis.