Controlled Trial of the Sequential Use of Streptokinase and Ancrod in the Treatment of Deep Vein Thrombosis of Lower Limb

SummaryTreatment with streptokinase (‘Kabikinase’) was given to 26 patients with venographically confirmed deep vein thrombosis extending into the popliteal vein or above. Treatment was continued for 4 days and the patients were allocated randomly to oral anticoagulant therapy or a course of treatment with ancrod (‘Arvin’) for 6 days followed by oral anticoagulant therapy. The degree of thrombolysis as judged by further venographic examination at 10 days was not significantly different between the 2 groups. The majority of patients showed clinical improvement but there was no appreciable difference between the groups at 3 and 6 months. Haemorrhagic complications were a more serious problem during the period of treatment with ancrod than during the equivalent period in the control group.

Download Full-text

Comparison of 3 and 6 Months of Oral Anticoagulant Therapy After a First Episode of Proximal Deep Vein Thrombosis or Pulmonary Embolism and Comparison of 6 and 12 Weeks of Therapy After Isolated Calf Deep Vein Thrombosis

Circulation ◽

10.1161/01.cir.103.20.2453 ◽

2001 ◽

Vol 103 (20) ◽

pp. 2453-2460 ◽

Cited By ~ 255

Author(s):

Laurent Pinede ◽

Jacques Ninet ◽

Pierre Duhaut ◽

Sylvie Chabaud ◽

Sylvie Demolombe-Rague ◽

...

Keyword(s):

Pulmonary Embolism ◽

Deep Vein Thrombosis ◽

Anticoagulant Therapy ◽

Oral Anticoagulant ◽

Oral Anticoagulant Therapy ◽

Proximal Deep Vein Thrombosis ◽

First Episode ◽

Vein Thrombosis ◽

Deep Vein

Download Full-text

Individualized duration of oral anticoagulant therapy for deep vein thrombosis based on a decision model

Journal of Thrombosis and Haemostasis ◽

10.1046/j.1538-7836.2003.00466.x ◽

2003 ◽

Vol 1 (12) ◽

pp. 2523-2530 ◽

Cited By ~ 21

Author(s):

R. Vink ◽

R. A. Kraaijenhagen ◽

M. Levi ◽

H. R. Buller

Keyword(s):

Deep Vein Thrombosis ◽

Anticoagulant Therapy ◽

Oral Anticoagulant ◽

Decision Model ◽

Oral Anticoagulant Therapy ◽

Vein Thrombosis ◽

Deep Vein

Download Full-text

Optimal duration of oral anticoagulant therapy following deep vein thrombosis of lower limbs

Blood Coagulation & Fibrinolysis ◽

10.1097/00001721-199607000-00001 ◽

1996 ◽

Vol 7 (5) ◽

pp. 507-514 ◽

Cited By ~ 16

Author(s):

H. Bounameaux ◽

P. de Moerloose ◽

F. P. Sarasin

Keyword(s):

Deep Vein Thrombosis ◽

Anticoagulant Therapy ◽

Oral Anticoagulant ◽

Oral Anticoagulant Therapy ◽

Lower Limbs ◽

Vein Thrombosis ◽

Optimal Duration ◽

Deep Vein

Download Full-text

Duration of Oral Anticoagulant Therapy after Proximal Deep Vein Thrombosis: a Decision Analysis

Thrombosis and Haemostasis ◽

10.1055/s-0038-1642432 ◽

1994 ◽

Vol 71 (03) ◽

pp. 286-291 ◽

Cited By ~ 24

Author(s):

François P Sarasin ◽

Henri Bounameaux

Keyword(s):

Deep Vein Thrombosis ◽

Decision Analysis ◽

Anticoagulant Therapy ◽

Oral Anticoagulant ◽

Oral Anticoagulant Therapy ◽

Oral Anticoagulants ◽

Bleeding Risk ◽

Lower Limbs ◽

Vein Thrombosis ◽

Deep Vein

SummaryThe optimal duration of oral anticoagulant therapy following proximal deep vein thrombosis (DVT) in the lower limbs remains controversial. To compare the risk benefit tradeoffs for different treatment durations (6 to 24 weeks) we constructed a Markov-based decision analysis model which explicitly balances the time-dependent declining risk of recurrent thrombosis and pulmonary embolism against the risk of major hemorrhagic complications. Specifically, we determined the threshold below which the risk of recurrent DVT exceeds the risk of major hemorrhage if anticoagulant therapy is discontinued, and above which the benefits provided by oral anticoagulants are outweighed by their risk.Our model shows that for patients with a low hemorrhagic risk (0.5%/month), the benefit yielded by oral anticoagulants breaks off beyond the 4th month of therapy, while patients with moderate (1%/month) to high (2%/month) bleeding risk will no longer benefit from the therapy after 3 or 2.5 months, respectively.In conclusion, our model supports the validity of the usually recommended duration of 3 months of oral anticoagulation after proximal vein thrombosis in the lower limbs, but suggests that this duration should be modulated between 2.5 and 4 months depending upon individual bleeding risk. Since clinical trials can hardly handle the complexity of the addressed issue, such a model may prove very helpful in daily clinical practice.

Download Full-text

Comparison of 3 and 6 months of oral anticoagulant therapy after a first episode of proximal deep vein thrombosis or pulmonary embolism and comparison of 6 and 12 weeks of therapy after isolated calf deep vein thrombosis

ACC Current Journal Review ◽

10.1016/s1062-1458(01)00466-4 ◽

2001 ◽

Vol 10 (6) ◽

pp. 32

Author(s):

L Pinede ◽

J Ninet ◽

P Duhaut

Keyword(s):

Pulmonary Embolism ◽

Deep Vein Thrombosis ◽

Anticoagulant Therapy ◽

Oral Anticoagulant ◽

Oral Anticoagulant Therapy ◽

Proximal Deep Vein Thrombosis ◽

First Episode ◽

Vein Thrombosis ◽

Deep Vein

Download Full-text

Bevacizumab Plus Direct Oral Anticoagulant Therapy in Ovarian Cancer Patients with Distal Deep Vein Thrombosis

Clinical Drug Investigation ◽

10.1007/s40261-019-00757-w ◽

2019 ◽

Vol 39 (4) ◽

pp. 395-400 ◽

Cited By ~ 2

Author(s):

Shinichi Komiyama ◽

Masaru Nagashima ◽

Tomoko Taniguchi ◽

Takayuki Rikitake ◽

Mineto Morita

Keyword(s):

Ovarian Cancer ◽

Deep Vein Thrombosis ◽

Cancer Patients ◽

Anticoagulant Therapy ◽

Oral Anticoagulant ◽

Oral Anticoagulant Therapy ◽

Direct Oral Anticoagulant ◽

Vein Thrombosis ◽

Distal Deep Vein Thrombosis ◽

Deep Vein

Download Full-text

CONTROLLED TRIAL OF ANCROD AND HEPARIN IN TREATMENT OF DEEP-VEIN THROMBOSIS OF LOWER LIMB

The Lancet ◽

10.1016/s0140-6736(72)90678-2 ◽

1972 ◽

Vol 299 (7742) ◽

pp. 113-115 ◽

Cited By ~ 24

Author(s):

J.A. Davies ◽

A.A. Sharp ◽

M.V. Merrick ◽

J.M. Holt

Keyword(s):

Deep Vein Thrombosis ◽

Lower Limb ◽

Controlled Trial ◽

Vein Thrombosis ◽

Deep Vein

Download Full-text

The Risk and Efficacy of Anticoagulant Therapy in the Treatment of Thromboembolic Complications in Patients with Primary Malignant Brain Tumors

Neurosurgery ◽

10.1227/00006123-199007000-00010 ◽

1990 ◽

Vol 27 (1) ◽

pp. 74-77 ◽

Cited By ~ 60

Author(s):

Eric Altschuler ◽

Hans Moosa ◽

Robert G. Selker ◽

Frank T. Vertosick

Keyword(s):

Pulmonary Embolism ◽

Deep Vein Thrombosis ◽

Anticoagulant Therapy ◽

Warfarin Therapy ◽

Oral Anticoagulant Therapy ◽

Effective Means ◽

Thromboembolic Complications ◽

Intratumoral Hemorrhage ◽

Vein Thrombosis ◽

Deep Vein

Abstract Twenty-three patients with malignant glial neoplasms were treated with anticoagulant therapy for thromboembolic complications. Fifteen patients had deep vein thrombosis alone, and 8 patients had both deep vein thrombosis and pulmonary embolism. Serum prothrombin times were maintained at 1.25 times control for an average of 5.8 months per patient, for a total patient exposure to warfarin therapy of 132 patient-months (11 patient-years). Only 1 patient suffered a recurrent pulmonary embolism, and this occurred during an episode of gastrointestinal bleeding, when anticoagulant therapy had to be discontinued prematurely. All patients were followed with serial computed tomographic or magnetic resonance imaging scans, and no patient showed radiographic evidence of intratumoral hemorrhage either during or after warfarin therapy. One patient, who died from a large recurrent glioblastoma, was found at autopsy to have scattered foci of intratumoral hemorrhage. This series, together with a review of the available literature, suggests that oral anticoagulant therapy is both a safe and effective means of treating thromboembolic complications in patients with residual malignant glial tumors.

Download Full-text