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Blood Res.  2021 Mar;56(1):6-16. 10.5045/br.2021.2020083.

Updated recommendations for the treatment of venous thromboembolism

Affiliations
  • 1Division of Hematology-Medical Oncology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Department of Hematology-Oncology, Korea.
  • 2Chonnam National University Hwasun Hospital, Hwasun, Korea.
  • 3Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
  • 4Division of Hematology and Oncology, Department of Internal Medicine, Dong-A University College of Medicine, Dong-A University Hospital, Busan, Korea.
  • 5Division of Pediatric Hematology and Oncology, Department of Pediatrics, Yonsei University College of Medicine, Yonsei University Health System, Jeonju, Korea.
  • 6Department of Oncology and Hematology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Department of Internal Medicine, Jeonju, Korea.
  • 7Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, Korea.
  • 8Veterans Health Service Medical Center, Seoul, Korea.
  • 9Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 10Department of Laboratory Medicine, Yonsei University College of Medicine, Severance Hospital, Seoul, Korea.
  • 11Division of Hematology-Medical Oncology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 12Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, Department of Internal Medicine, Seoul, Korea
  • 13Ewha Womans University College of Medicine, Seoul, Korea.
  • 14Daegu Catholic University School of Medicine, Daegu Catholic University Hospital, Daegu, Department of Laboratory Medicine, Korea.
  • 15Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
  • 16University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
  • 17Soonchunhyang University Seoul Hospital, Seoul, Korea.
  • 18Department of Pediatrics, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 19Division of Hematology-Oncology, Department of Internal Medicine, CHA University School of Medicine, Seongnam, Korea.

Abstract

Venous thromboembolism (VTE), which includes pulmonary embolism and deep vein thrombosis, is a condition characterized by abnormal blood clot formation in the pulmonary arteries and the deep venous vasculature. It is often serious and sometimes even fatal if not promptly and appropriately treated. Moreover, the later consequences of VTE may result in reduced quality of life. The treatment of VTE depends on various factors, including the type, cause, and patient comorbidities. Furthermore, bleeding may occur as a side effect of VTE treatment. Thus, it is necessary to carefully weigh the benefits versus the risks of VTE treatment and to actively monitor patients undergoing treatment. Asian populations are known to have lower VTE incidences than Western populations, but recent studies have shown an increase in the incidence of VTE in Asia. A variety of treatment options are currently available owing to the introduction of direct oral anticoagulants. The current VTE treatment recommendation is based on evidence from previous studies, but it should be applied with careful consideration of the racial, genetic, and social characteristics in the Korean population.

Keyword

Venous thromboembolism; Deep vein thrombosis; Pulmonary embolism; Anticoagulants

Figure

  • Fig. 1 Overview of anticoagulant therapy for venous thromboembolism. a)Doses can be modified according to organ function, body weight, or concomitant medications. Abbreviations: INR, international normalized ratio; LMWH, low-molecular-weight heparin; UFH, unfractionated heparin. Abbreviations: INR, international normalized ratio; LMWH, low-molecular-weight heparin; UFH, unfractionated heparin.

  • Fig. 2 Pregnancy-adapted YEARS algorithm for suspected acute pulmonary embolism in pregnant patients. a)If a woman has clinical sign of DVT, check compression ultrasonography of the symptomatic leg and initiate anticoagulant if DVT is confirmed. b)Initiate ant-icoagulant if chest CTPA indicates PE. Abbreviations: CTPA, computed pulmonary angiography; DVT, deep vein thrombosis; PE, pulmonary embolism.


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