Thromboembolism

In addition to anticoagulation, some patients with VTE may benefit from adjunctive therapies, such as thrombolysis, catheter-directed interventions, or inferior vena cava (IVC) filters, to remove or prevent thrombus migration.

These therapies are not routinely recommended by the current guidelines except for specific indications, such as massive PE, iliofemoral DVT, or contraindications to anticoagulation.

[3] The type of anticoagulant used for indefinite therapy is of secondary importance, but low-dose DOACs may offer a convenient and safer option for some patients.

The main goals of ATE management are to restore blood flow, prevent further thrombosis, and treat the underlying cause.

Antithrombotic therapy consists of antiplatelet agents, such as aspirin or clopidogrel, or anticoagulants, such as heparin or DOACs, depending on the indication and contraindications.

Revascularization procedures include thrombolysis, thrombectomy, angioplasty, stenting, or bypass surgery and are indicated for patients with severe or limb-threatening ischemia or failed medical therapy.

The duration of antithrombotic therapy for ATE is variable, depending on the type and location of the thrombus, the presence of a prosthetic device, and the bleeding risk.

Animation showing the formation of an occlusive blood clot in a vein. Several platelets attach to the lips of the valve, narrowing the opening and causing more platelets and red blood cells to pool and clot. Clotting of immobile blood on both sides of the blockage can cause the clot to spread in both directions. Acute blockage (embolism) of a blood vessel by a thrombus that has detached from its place of formation (on the wall of a vessel) and entered the circulating blood. As a result of this blockage, blood flow in the vessel stops—a condition called thromboembolism. [ 1 ]