Capítulo de controversias en hemostasia y trombosis / Haemostasia and thrombosis. A controversial chapter

RESUMO

When should we consider to stop anticoagulation (AO) in venous Thromboembolism? a)In a patient with resolved risk factor like surgery and proximal deep vein thrombosis (DVT) between 6 weeks and 3 months. In a patient with distal DVT 6 weeks of anticoagulation is enough. b)A patient with unknow risk factor (spontanous DVT) with thrombophilic study negative at least 6 month of AO. It may be better one year? c)A patient with low risk thrombophilia, first event, for example Factor V Leiden heterocigote, hyperhomocysttenemia, Prothombin 2021 A, abnormal fibrinolytic system, at least 6 month of AO. d)In a patient with high risk Thrombophilia, first event, as Protein S,C or Antithrombin deficiency, antiphospholipid antibodies, or two low risk thrombophilic factors combined 6 month to one year of AO and if the risk factor do not resolve treatment should be continued indefinitely. e)Patients with ongoing risk factorslike second idiopathic DVT, an active malignancy, a pulmonary embolism with pulmonary chronic hypertention or a DVT with inferrior vena cava interruption without contraindication to Ao should continue with AO indefinitely