Skip to main content
SpringerLink
Log in

Approaches to the Prophylaxis and Treatment of Venous and Cardiac Thromboembolic Disease

  • Chapter
  • First Online:
Antiplatelet and Anticoagulation Therapy

Part of the book series: Current Cardiovascular Therapy ((CCT))

  • 1519 Accesses

Abstract

Rudolf Virchow, the 19th century German physician, described three factors that contribute to venous thrombosis: (1) Phenomena due to irritation of the vessel and its surroundings; (2) Phenomena due to blood coagulation; and (3) Phenomena due to the interruption of the blood stream [1]. An updated description of these factors is: (1) Alteration in blood flow (i.e. stasis); (2) Vascular endothelial injury; and (3) Hypercoagulability. Clot formation does not require the presence of all factors; however there is an additive risk with increasing factors. Thus, this triad forms the basis for risk factor analysis for venous thromboembolism (VTE).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 34.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 49.95
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Bagot CN, Arya R. Virchow and his triad: a question of attribution. Br J Haematol. 2008;134(2):180–90.

    Article  Google Scholar 

  2. Khan S, Dickerman JD. Hereditary thrombophilia. Thromb J. 2006;4:15. doi:10.1186/1477-9560-4-15.

    Article  PubMed  Google Scholar 

  3. Baglin T, Luddington R, Brown K, Baglin C. Incidence of recurrent venous thromboembolism in relation to clinical and thrombophilic risk factors: prospective cohort study. Lancet. 2003;362:523–6.

    Article  PubMed  Google Scholar 

  4. Dalen JE. Should patients with venous thromboembolism be screened for thrombophilia? Am J Med. 2008;121:458–63.

    Article  PubMed  Google Scholar 

  5. Heit JA. The epidemiology of venous thromboembolism in the community. Arterioscler Thromb Vasc Biol. 2008;28:370–2.

    Article  PubMed  CAS  Google Scholar 

  6. Heit JA, Melton LJ, Lohse CM, et al. Incidence of venous thromboembolism in hospitalized patients vs community residents. Mayo Clin Proc. 2001;76:1102–10.

    Article  PubMed  CAS  Google Scholar 

  7. Cushman M. Epidemiology and risk factors for venous thrombosis. Semin Hematol. 2007;44(2):62–9.

    Article  PubMed  Google Scholar 

  8. Meignan M, Rosso J, Gauthier H, et al. Systematic lung scans reveal a high frequency of silent pulmonary embolism in patients with proximal deep venous thrombosis. Arch Intern Med. 2000;160:159–64.

    Article  PubMed  CAS  Google Scholar 

  9. Ansell JE. Venous thrombosis. In: Creager MA, Dzau VJ, Loscalzo J, editors. Vascular medicine: a companion to Braunwald’s heart disease. 1st ed. Philadelphia, PA: Elsevier Inc.; 2006. p. 743–64.

    Google Scholar 

  10. Leclerc JR. Natural history of venous thromboembolism. In: Leclerc JR, editor. Venous thromboembolic disorders. Philadelphia: Lea & Febiger; 1991. p. 166–75.

    Google Scholar 

  11. White RH. The epidemiology of venous thromboembolism. Circulation. 2003;107:I–4-I-8.

    Article  Google Scholar 

  12. Falck-Ytter Y, Francis CW, Johanson NA, et al. Prevention of VTE in orthopedic surgery patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American college of chest physicians evidence-based clinical practice guidelines. Chest. 2012;141:7S–47.

    Article  Google Scholar 

  13. Gould MK, Garcia DA, Wren SM, et al. Prevention of VTE in nonorthopedic surgical patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American college of chest physicians evidence-based clinical practice guidelines. Chest. 2012;141:e227S–77.

    Article  PubMed  CAS  Google Scholar 

  14. Kahn SR, Lim W, Dunn AS, et al. Prevention of VTE in nonsurgical patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American college of chest physicians evidence-based clinical practice guidelines. Chest. 2012;141:e195S–226.

    Article  PubMed  CAS  Google Scholar 

  15. Caprini JA. Thrombosis risk assessment as a guide to quality patient care. Dis Mon. 2005;51:70–8.

    Article  PubMed  Google Scholar 

  16. Caprini JA, Arcelus JI, Hasty JH, Tamhane AC, Fabrega F. Clinical assessment of venous thromboembolic risk in surgical patients. Semin Thromb Hemost. 1991;17 suppl 3:304–12.

    PubMed  Google Scholar 

  17. Rogers SO, Kilaru RK, Hosokawa P, et al. Multivariable predictors of postoperative venous thromboembolic events after general and vascular surgery: results from the patient safety in surgery study. J Am Coll Surg. 2007;204:1211–21.

    Article  PubMed  Google Scholar 

  18. Barbar S, Noventa F, Rossetto V, et al. A risk assessment model for the identification of hospitalized medical patients at risk for venous thromboembolism: the Padua prediction score. J Thromb Haemost. 2010;8:2450–7.

    Article  PubMed  CAS  Google Scholar 

  19. Lederle FA, Zylla D, MacDonald R, Wilt TJ. Venous thromboembolism prophylaxis in hospitalized medical patients and those with stroke: a background review for an American college of physicians clinical practice guideline. Ann Intern Med. 2011;155:602–15.

    PubMed  Google Scholar 

  20. Qaseem A, Chou R, Humphrey LL, et al. Venous thromboembolism prophylaxis in hospitalized patients: a clinical practice guideline from the American college of physicians. Ann Intern Med. 2011;155:625–32.

    PubMed  Google Scholar 

  21. Kakkar AK, Cimminiello C, Goldhaber SZ, et al. Low-molecular-weight heparin and mortality in acutely ill medical patients. N Engl J Med. 2011;365:2463–72.

    Article  PubMed  CAS  Google Scholar 

  22. Lansberg MG, O’Donnell MJ, Khatri P, et al. Antithrombotic and thrombolytic therapy for ischemic stroke: antithrombotic therapy and prevention of thrombosis, 9th ed: American college of chest physicians evidence-based clinical practice guidelines. Chest. 2012;141:e601S–36.

    Article  PubMed  CAS  Google Scholar 

  23. Eriksson BI, Dahl OE, Rosencher N, et al. Oral dabigatran etexilate vs. subcutaneous enoxaparin for the prevention of venous thromboembolism after total knee replacement: the RE-MODEL randomized trial. J Thromb Haemost. 2007;5(11):2178–85.

    Article  PubMed  CAS  Google Scholar 

  24. Eriksson BI, Dahl OE, Rosencher N, et al. Dabigatran etexilate versus enoxaparin for prevention of venous thromboembolism after total hip replacement: a randomized, double-blind, non-inferiority trial. Lancet. 2007;370(9591):949–56.

    Article  PubMed  CAS  Google Scholar 

  25. Ginsberg JS, Davidson BL, Comp PC, et al. Oral thrombin inhibitor dabigatran etexilate vs North American enoxaparin regimen for prevention of venous thrombosis after knee arthroplasty surgery. J Arthroplasty. 2009;24(1):1–9.

    Article  PubMed  Google Scholar 

  26. Lassen MR, Gallus A, Raskob GE, et al. Apixaban versus enoxaparin for thromboprophylaxis after hip replacement. N Eng J Med. 2010;363:2487–98.

    Article  CAS  Google Scholar 

  27. Lassen MR, Raskob GE, Gallus A, et al. Apixaban versus enoxaparin for thromboprophylaxis after knee replacement (ADVANCE-2): a randomized double-blind trial. Lancet. 2010;375:807–15.

    Article  PubMed  CAS  Google Scholar 

  28. Lassen MR, Raskob GE, Gallus A, et al. Apixaban or enoxaparin for thromboprophylaxis after knee replacement. N Eng J Med. 2009;361:594–604.

    Article  CAS  Google Scholar 

  29. Eriksson BI, Borris LC, Friedman RJ, et al. Rivaroxaban versus enoxaparin for thromboprophylaxis after hip arthroplasty. N Eng J Med. 2008;358:2765–75.

    Article  CAS  Google Scholar 

  30. Lassen MR, Ageno W, Borris LC, et al. Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty. N Eng J Med. 2008;358:2776–86.

    Article  CAS  Google Scholar 

  31. Turpie AGG, Lassen MR, Davidson BL, Bauer KA, Gent M, Kwong LM, et al. Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty (RECORD4): a randomised trial. Lancet. 2009;373(9676):1673–80.

    Article  PubMed  CAS  Google Scholar 

  32. Cohen A, Spiro T, Buller H, Haskell L, Hu D, Hull R, et al. Rivaroxaban compared with enoxaparin for the prevention of venous thromboembolism in acutely Ill medical patients. In: American College of Cardiology 60th Annual Scientific Session and Expo 5 April 2011; New Orleans, LA.

    Google Scholar 

  33. Goldhaber SZ, Leizorovicz A, Kakkar AK, Haas SK, Merli G, Knabb RM, et al. Apixaban versus enoxaparin for thromboprophylaxis in medically ill patients. N Engl J Med. 2011;365(23):2167–77.

    Article  PubMed  CAS  Google Scholar 

  34. Glynn RJ, Danielson E, Fonseca FAH, et al. A randomized trial of rosuvastatin in the prevention of venous thromboembolism. N Eng J Med. 2009;360:1851–61.

    Article  CAS  Google Scholar 

  35. Wells PS, Anderson DR, Bormanis J, et al. Value of assessment of pretest probability of deep-vein thrombosis in clinical management. Lancet. 1997;350:1795–8.

    Article  PubMed  CAS  Google Scholar 

  36. Wells PS, Anderson DR, Rodger M, et al. Evaluation of D-dimer in the diagnosis of suspected deep-vein thrombosis. N Engl J Med. 2003;349:1227–35.

    Article  PubMed  CAS  Google Scholar 

  37. Bounameaux H, de Moerloose P, Perrier A, et al. D-dimer testing in suspected venous thromboembolism: an update. QJM. 1997;90:437–42.

    Article  PubMed  CAS  Google Scholar 

  38. Frost SD, Brotman DJ, Michota FA. Rational use of D-dimer measurement to exclude acute venous thromboembolic disease. Mayo Clin Proc. 2003;78:1385–91.

    Article  PubMed  CAS  Google Scholar 

  39. Elliott CG, Lovelace TD, Brown LM, Adams D. Diagnosis: Imaging techniques. Clin Chest Med. 2010;31:641–57.

    Article  PubMed  Google Scholar 

  40. Bates SM, Jaeschke R, Stevens SM, et al. Diagnosis of DVT: antithrombotic therapy and prevention of thrombosis, 9th ed: American college of chest physicians evidence-based clinical practice guidelines. Chest. 2012;141:e351S–418.

    Article  PubMed  CAS  Google Scholar 

  41. Christopher Study Investigators Writing Group. Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D-dimer testing, and computed tomography. JAMA. 2006;295:172–9.

    Article  Google Scholar 

  42. Wells PS, Anderson DR, Rodger M, et al. Derivation of a simple clinical model to categorize patients probability of pulmonary embolism: increasing the models utility with the SimpliRED D-dimer. Thromb Haemost. 2000;83(3):416–20.

    PubMed  CAS  Google Scholar 

  43. Wells PS, Anderson DR, Rodger M, et al. Excluding pulmonary embolism at the bedside without diagnostic imaging: management of patients with suspected pulmonary embolism presenting to the emergency department by using a simple clinical model and D-dimer. Ann Intern Med. 2001;135:98–107.

    PubMed  CAS  Google Scholar 

  44. Wicki J, Perneger TV, Junod AF, et al. Assessing clinical probability of pulmonary embolism in the emergency ward: a simple score. Arch Intern Med. 2001;161:92–7.

    Article  PubMed  CAS  Google Scholar 

  45. Sostman HD, Stein PD, Gottschalk A, Matta F, Hull R, Goodman L. Acute pulmonary embolism: Sensitivity and specificity of ­ventilation-perfusion scintigraphy in PIOPED II study. Radiology. 2008;246:941–6.

    Article  PubMed  Google Scholar 

  46. PIOPED Investigators. Value of the ventilation/perfusion scan in acute pulmonary embolism. Results of the prospective investigation of pulmonary embolism diagnosis (PIOPED). JAMA. 1990;263(20):2753–9.

    Article  Google Scholar 

  47. Agnelli G, Becattini C. Acute pulmonary embolism. N Engl J Med. 2010;363:266–74.

    Article  PubMed  CAS  Google Scholar 

  48. Kearon C, Akl EA, Comerota AJ, et al. Antithrombotic therapy for VTE disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American college of chest physicians evidence-based clinical practice guidelines. Chest. 2012;141(2 Suppl):e419S–94.

    Article  PubMed  CAS  Google Scholar 

  49. ATTRACT Study. Study overview and rationale. Washington University School of Medicine. 2009. http://www.attract.wustl.edu/dvt-study-overview.

  50. Jaff MR, McMurtry MS, et al. Management of massive and submassive PE, ileofemoral DVT and chronic thromboembolic pulmonary hypertension: a scientific statement from the American heart association. Circulation. 2011;123:1788–830.

    Article  PubMed  Google Scholar 

  51. Aujesky D, Roy PM, et al. Outpatient versus inpatient treatment for patients with acute pulmonary embolism: an international, open-label, randomized, non-inferiority trial. Lancet. 2011;378:41–8.

    Article  PubMed  Google Scholar 

  52. Lee AY, Levine MN, Baker RI, et al. Low-molecular-weight heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer. N Eng J Med. 2003;349:146–53.

    Article  CAS  Google Scholar 

  53. Prandoni P, Noventa F, Ghirarduzzi A, et al. The risk of recurrent venous thromboembolism after discontinuing anticoagulation in patients with acute proximal deep vein thrombosis or pulmonary embolism. A prospective cohort study in 1,626 patients. Haemato­logica. 2007;92:199–205.

    Article  PubMed  Google Scholar 

  54. Goldhaber SZ. Deep venous thrombosis and pulmonary thromboembolism. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, editors. Harrison’s Principles of internal medicine. 18th ed. New York, NY: McGraw-Hill; 2012. p. 2170–7.

    Google Scholar 

  55. Verhovsek M, Douketi JD, et al. Systematic review: D-dimer to predict recurrent disease after stopping anticoagulant therapy for unprovoked venous thromboembolism. Ann Intern Med. 2008;149:481–90.

    PubMed  Google Scholar 

  56. Douketis J, Tosetto A, Marcucci M, et al. Patient-level meta-analysis: Effect of measurement timing, threshold, and patient age on ability of D-dimer testing to assess recurrence risk after unprovoked venous thromboembolism. Ann Intern Med. 2010;153:523–31.

    PubMed  Google Scholar 

  57. Prandoni P, Prins MH, Lensing AWA, Ghirarduzzi A, Ageno W, Imberti D, et al. Residual thrombosis on ultrasonography to guide the duration of anticoagulation in patients with deep venous thrombosis: a randomized trial. Ann Intern Med. 2009;150:577–85.

    PubMed  Google Scholar 

  58. Le Gal G, Carrier M, Kovacs MJ, et al. Residual vein obstruction as a predictor f or recurrent thromboembolic events after a first unprovoked episode: data from the REVERSE cohort study. J Thromb Haemost. 2011;9:1126–32.

    Article  Google Scholar 

  59. Carrier M, Rodger MA, Wells PS, Righini M, Le Gal G. Residual vein obstruction to predict the risk of recurrent venous thromboembolism in patients with deep vein thrombosis: a systematic review and meta-analysis. J Thromb Haemost. 2011;9:1119–25.

    Article  PubMed  CAS  Google Scholar 

  60. Rodger MA, Kahn SR, Wells PS, Anderson DA, Chagnon I, Le Gal G, et al. Identifying unprovoked thromboembolism patients at low risk for recurrence who can discontinue anticoagulant therapy. CMAJ. 2008;179(5):417–26.

    Google Scholar 

  61. Tosetto A, Iorio A, Marcucci M, Baglin T, Cushman M, Eichinger S, et al. Predicting disease recurrence in patients with previous unprovoked venous thromboembolism: a proposed prediction score (DASH). J Thromb Haemost. 2012;10:1019–25.

    Google Scholar 

  62. Schulman S, Kearon C, Kakkar AK, et al. Dabigatran versus warfarin in the treatment of acute venous thromboembolism. N Engl J Med. 2009;361:2342–52.

    Article  PubMed  CAS  Google Scholar 

  63. Einstein Investigators. Oral rivaroxaban for symptomatic venous thromboembolism. N Eng J Med. 2010;363:2499–510.

    Article  Google Scholar 

  64. Einstein-PE Investigators. Oral rivaroxaban for the treatment of symptomatic pulmonary embolism. N Engl J Med. 2012;366:1287–97.

    Article  Google Scholar 

  65. Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA, et al. ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation—executive summary: a report of the American college of cardiology/American heart association task force and the European society of cardiology committee for practice guidelines (writing committee to revise the 2001 guidelines for the management of patients with atrial fibrillation). J Am Coll Cardiol. 2006;48:854–906.

    Article  PubMed  Google Scholar 

  66. Marchlinski F. The tachyarrhythmias. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, editors. Harrison’s Principles of internal medicine. 18th ed. New York, NY: McGraw-Hill; 2012. p. 1878–900.

    Google Scholar 

  67. Singer DE, Albers GW, Dalen JE, et al. Antithrombotic therapy in atrial fibrillation. American college of chest physicians evidence-based clinical practice guidelines (8th edition). Chest. 2008;133:546S–92.

    Article  PubMed  CAS  Google Scholar 

  68. Conen D, Chae CU, Glynn RJ, et al. Risk of death and cardiovascular events in initially healthy women with new-onset atrial fibrillation. JAMA. 2011;305(20):2080–7.

    Article  PubMed  CAS  Google Scholar 

  69. Lin HJ, Wolf PA, Kelly-Hayes M, Beiser AS, Kase CS, Benjamin EJ, et al. Stroke severity in atrial fibrillation. The Framingham study. Stroke. 1996;27:1760–4.

    Article  PubMed  CAS  Google Scholar 

  70. Gage BF, Waterman AD, Shannon W, et al. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA. 2001;285(22):2864–70.

    Article  PubMed  CAS  Google Scholar 

  71. Gage BF, Yan Y, Milligan PE, Waterman AD, Culverhouse R, Rich MW, et al. Clinical classification schemes for predicting hemorrhage: results from the National Registry of Atrial Fibrillation (NRAF). Am Heart J. 2006;151:713–9.

    Article  PubMed  Google Scholar 

  72. Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJ, Lip GYH. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro heart survey. Chest. 2010;138(5):1093–100.

    Article  PubMed  Google Scholar 

  73. Camm AJ, Kirchhof P, Lip GYH, et al. Guidelines for the management of atrial fibrillation: the task force for the management of atrial fibrillation of the European society of cardiology (ESC). Eur Heart J. 2010;31:2369–429.

    Article  PubMed  Google Scholar 

  74. Wann LS, Curtis AB, January CT, Ellenbogen KA, Lowe JE, Estes 3rd NAM, Page RL, Ezekowitz MD, Slotwiner DJ, Jackman WM, Stevenson WG, Tracy CM. Writing on behalf of the 2006 ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation writing committee. 2011 ACCF/AHA/HRS focused update on the management of patients with atrial fibrillation (updating the 2006 guideline): a report of the American college of cardiology foundation/American heart association task force on practice guidelines. Circulation. 2011;123:104–23.

    Article  PubMed  Google Scholar 

  75. You JJ, Singer D, Howard PA, et al. Antithrombotic therapy for atrial fibrillation: antithrombotic therapy and prevention of thrombosis, 9th ed: American college of chest physicians evidence-based clinical practice guidelines. Chest. 2012;141:e531S–75.

    Article  PubMed  CAS  Google Scholar 

  76. ACTIVE Writing Group. Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation in the atrial fibrillation clopidogrel trial with irbesartan for prevention of vascular events (ACTIVE W): a randomised controlled trial. Lancet. 2006;367:1903–12.

    Article  Google Scholar 

  77. Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361:1139–51.

    Article  PubMed  CAS  Google Scholar 

  78. Patel MR, Mahaffey KW, Garg J, Pan G, Singer DE, Hacke W, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Eng J Med. 2011;365:883–91.

    Article  CAS  Google Scholar 

  79. Granger CB, Alexander JH, McMurray JV, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011;365:981–92.

    Article  PubMed  CAS  Google Scholar 

  80. Connolly SJ, Eikelboom J, Joyner C, Diener HC, Hart R, Golitsyn S, et al. Apixaban in patients with atrial fibrillation. N Eng J Med. 2011;364:806–17.

    Article  CAS  Google Scholar 

  81. Viles-Gonzalez JF, Fuster V, Halperin JL. New anticoagulants for prevention of stroke in patients with atrial fibrillation. J Cardiovasc Electrophysiol. 2011;22:948–55.

    Article  PubMed  Google Scholar 

  82. Salem DN, O’Gara PT, Madias C, Pauker SG. Valvular and structural heart disease. American college of chest physicians evidence-based clinical practice guidelines (8th edition). Chest. 2008;133:593S–629.

    Article  PubMed  Google Scholar 

  83. Whitlock RP, Sun JC, Fremes SE, Rubens FD, Teoh KH. Antithrombotic and thrombolytic therapy for valvular disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American college of chest physicians evidence-based clinical practice guidelines. Chest. 2012;141:e576S–600.

    Article  PubMed  CAS  Google Scholar 

  84. Bauer KA. The thrombophilias: well-defined risk factors with uncertain therapeutic implications. Ann Intern Med. 2001;135:367–73.

    PubMed  CAS  Google Scholar 

  85. Eriksson BI, Dahl OE, Huo MH, et al. Oral dabigatran versus enoxaparin for thromboprophylaxis after primary total hip arthroplasty (RE-NOVATE II): a randomised, double-blind, non-inferiority trial. Thromb Haemost. 2011;105:721–9.

    Article  PubMed  CAS  Google Scholar 

  86. Kakkar AK, Brenner B, Dahl OE, et al. Extended duration rivaroxaban versus short-term enoxaparin for the prevention of venous thromboembolism after total hip arthroplasty: a double-blind, randomised controlled trial. Lancet. 2008;372:31–9.

    Article  PubMed  CAS  Google Scholar 

  87. Schulman S, Kakkar AK, Schellong SM, et al. A randomized trial of dabigatran versus warfarin in the treatment of acute venous thromboembolism (RE-COVER II). American Society of Hematology 2011 Annual Meeting; 12 Dec 2011; San Diego, CA. Abstract 205

    Article  PubMed  CAS  Google Scholar 

  88. Tapson VF. Acute pulmonary embolism. N Engl J Med. 2008;358:1037–52.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, Lenox Hill Hospital, 100 E. 77th Street, New York, NY, 10075, USA

    Christopher Dittus D.O., M.P.H. & Jack Ansell M.D.

Authors
  1. Christopher Dittus D.O., M.P.H.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jack Ansell M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christopher Dittus D.O., M.P.H. .

Editor information

Editors and Affiliations

  1. Stamford Street 150, London, SE1 9NH, United Kingdom

    Albert Ferro

  2. Albuquerque, 87131, New Mexico, USA

    David A. Garcia

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag London

About this chapter

Cite this chapter

Dittus, C., Ansell, J. (2013). Approaches to the Prophylaxis and Treatment of Venous and Cardiac Thromboembolic Disease. In: Ferro, A., Garcia, D. (eds) Antiplatelet and Anticoagulation Therapy. Current Cardiovascular Therapy. Springer, London. https://doi.org/10.1007/978-1-4471-4297-3_5

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-4297-3_5

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4296-6

  • Online ISBN: 978-1-4471-4297-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation