This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ansell, J. Search for Related Content PubMed PubMed Citation Articles by Ansell, J. Related Collections Deep vein thrombosis Coumarins

(Circulation. 2005;112:298-299.)
© 2005 American Heart Association, Inc.

Editorial

Vena Cava Filters

Do We Know All That We Need to Know?

Jack Ansell, MD

From the Department of Medicine, Boston University School of Medicine, Boston, Mass.

Correspondence to Jack Ansell, MD, Dept of Medicine, Boston University School of Medicine, 88 East Newton St, Boston, MA 02118. E-mail jack.ansell@bmc.org

Key Words: Editorials • anticoagulants • thrombosis • vena caval filters

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Considerable progress has been made in the last decade in understanding the natural history of "treated" venous thromboembolism (VTE). VTE occurs at a rate of 1/1000 in the general population¹ and significantly increases with age, especially after age 60, with rates as high as 1/100.² Duplex ultrasonography has largely replaced venography as the diagnostic test of choice for deep venous thrombosis (DVT),³ and spiral CT pulmonary angiography is rapidly replacing ventilation/perfusion lung scans as the diagnostic test of choice for pulmonary embolism (PE).⁴ Multiple agents are now available for the initial treatment of VTE including unfractionated heparin, low-molecular-weight heparin, and fondaparinux,⁵ and although the vitamin K antagonists remain the sole oral agents for the long-term treatment of VTE, new oral alternatives are on the horizon.⁶ As the result of large randomized controlled trials the secondary prevention of recurrent VTE has improved, with the duration of therapy now based on an understanding of the initial inciting event and the presence of ongoing risk factors.⁷ Patients with idiopathic DVT or persistent risk factors require anticoagulant therapy for a minimum of 6 months, and more likely, 12 months, with a cumulative risk of recurrence as high as 30% at 8 years.⁸ For patients with cancer and VTE, it has been shown that therapy with low-molecular-weight heparin for the first 3 to 6 months results in better outcomes than the outcomes of patients transitioned to warfarin early in the course of therapy.⁹ Unfortunately, the application of vena cava interruption has not undergone the same . . . [Full Text of this Article]

This article has been cited by other articles:

				M. P. Janjigian and B. E. Muhs Current Treatment of Acute Lower Extremity Deep Venous Thrombosis International Journal of Lower Extremity Wounds, March 1, 2008; 7(1): 15 - 20. [Abstract] [PDF]

				Do Vena Cava Filters Prevent PE? Journal Watch Cardiology, September 2, 2005; 2005(902): 5 - 5. [Full Text]