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J R Soc Med 1996;89:624-630
© 1996 Royal Society of Medicine

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Journal of the Royal Society of Medicine, Vol 89, Issue 11 624-630, Copyright © 1996 by Royal Society of Medicine

ORIGINAL ARTICLES

Anticoagulation in venous thrombosis

S Schulman
Department of Internal Medicine, Karolinska Hospital, Stockholm, Sweden.

Major studies addressing various aspects of the treatment of deep vein thrombosis are reviewed. It has lately been demonstrated that heparin should be dosed according to body weight and is preferably given as subcutaneous injections twice daily. Alternatively, low-molecular-weight heparins may be given in a fixed dose once daily, which does not require monitoring. Oral anticoagulation should be started concomitantly with heparin and targeted at an international normalized ratio of 2.0-3.0. This treatment should continue for a longer duration than previously accepted, in many cases for 6 months. For patients with contraindications to oral anticoagulation, secondary prophylaxis with a low-molecular-weight heparin is also effective and safe.
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