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Acta Phlebologica 2014 December;15(3):87-94

language: English

Beyond the treatment of venous thromboembolism: a clinical guide to the interpretation of thrombotic risk

Prisco D. 1, 2, Cenci C. 1, Ciucciarelli L. 1, 2, Cameli A. 1, 2, Silvestri E. 1, 2

1 Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy;
2 SOD Patologia Medica, AOU Careggi, Florence, Italy


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Venous thromboembolism (VTE) has a significant clinical and social impact due to its high incidence and significant rate of recurrence. Due to these aspects, the approach to VTE should include an accurate primary prevention of events and, on the other hand, an effective treatment, based on the stratification of patients according to their thrombotic risk. To this purpose, researches have been prompted to create clinically-relevant risk assessment models (RAMs) for hospitalized patients which include the main thrombotic risk factors and should provide a guidance to physicians to identify those patients at higher risk who may benefit from mechanical and/or pharmacological prophylaxis. The evaluation of the thrombotic risk is crucial also in the field of secondary VTE prevention, in order to identify patients who need long-term anticoagulation, after the three-month standard treatment. Over the last years, clinical trials and meta-analyses have identified male sex, site of VTE, residual vein obstruction and D-dimer levels after anticoagulation withdrawal as the main risk factors for VTE recurrence so this items were included, at varying extents, in the currently available prediction algorithms.

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