ABSTRACT
This chapter provides an overview of the basic principles of the treatment of venous thromboembolism (VTE), from initial presentation to determining optimal therapy and duration of anticoagulation to aggressive therapies and special circumstances. The objectives of treatment in patients with VTE are to prevent death from pulmonary embolism, to prevent recurrent VTE, and to prevent the post-thrombotic syndrome. Immediate anticoagulation is paramount in the initial treatment of the patient presenting with VTE. Rivaroxaban is Food and Drug Administration approved for VTE prophylaxis in patients undergoing hip or knee replacements, for stroke and systemic embolization prevention in patients with atrial fibrillation, and for VTE treatment. Although aspirin (ASA) is not a new agent, the use of ASA for the extended treatment of VTE after a standard course of therapy has gained renewed interest. If indefinite therapy is considered in patients with idiopathic VTE, decision making may be aided by D-dimer testing 1 month after completion of warfarin therapy.
