Pearls from 7/27/21 Medicine LEADS

The July 27, 2021 session of Duke Medicine LEADS featured Thomas Ortel, MD, PhD, presenting "Treatment of Venous Thromboembolism."

Here are pearls and takeaways from the session:

  1. Anticoagulate for 3-6 months for primary treatment of VTE/PE.  Anticoagulate indefinitely if the VTE/PE was unprovoked and consider indefinite anticoagulation if there were only minor transient or reversible risk factors. 
  2. Extended anticoagulation for secondary prevention has not been shown to increase patients’ risk for bleeding.  Consider using a lower dose of DOACs in this setting given equal efficacy as standard dose in preventing recurrent VTE. 
  3. For patients with DVT and/or PE who have completed primary treatment and will continue to receive secondary prevention, anticoagulation has been demonstrated to be more effective than aspirin.
  4. The presence or absence of thrombophilia should have a limited impact on the decision concerning duration of anticoagulant therapy.
  5. Patients with VTE and anti phospholipid syndrome should only be anticoagulated with vitK antagonists.
  6. Bariatric surgery can alter absorption of anticoagulants. Use vitK antagonists in patients who have undergone bariatric surgery to allow for close monitoring. 

Watch the recorded session

Duke Medicine Learning, Education, and Discussion Series (LEADS) takes place each Tuesday at 12 p.m. Learn more and see schedule of upcoming sessions.