Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), is t

 

Abstract

Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), is the third most common cause of vascular death after heart attack and stroke. Anticoagulation therapy is the cornerstone of VTE treatment. Despite such therapy, up to 50% of DVT patients develop post-thrombotic syndrome and up to 4% of PE patients develop chronic thromboembolic pulmonary hypertension. Therefore, better therapies are needed. Although the direct oral anticoagulants are more convenient and safer than warfarin for VTE treatment, bleeding remains the major side effect, particularly in cancer patients. Factor XII and factor XI have emerged as targets for new anticoagulants that may be safer. To reduce the complications of VTE, attenuation of thrombin activatable fibrinolysis inhibitor activity is under investigation in PE patients to enhance endogenous fibrinolysis whereas blockade of leukocyte interaction with the vessel wall is being studied to reduce the inflammation, which contributes to post-thrombotic syndrome in DVT patients. Focusing on these novel antithrombotic strategies, this paper (a) explains why safer anticoagulants are needed, (b) provides the rationale for factor XII and XI as targets for such agents, (c) reviews the data on the factor XII- and XI-directed anticoagulants under development, (d) describes novel therapies to enhance fibrinolysis and decrease inflammation in PE and DVT patients, respectively, and (e) offers insights into the opportunities for these novel VTE therapies.

PMID: 31917385 [PubMed - as supplied by publisher]

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pubmed: caandvteortroorpul

Minimally invasive cancer surgery is associated with a lower risk of venous thromboembolic events.

Minimally invasive cancer surgery is associated with a lower risk of venous thromboembolic events.

J Surg Oncol. 2020 Jan 08;:

Authors: Krimphove MJ, Reese S, Chen X, Marchese M, Cone E, Tully KH, Paciotti M, Kibel AS, Melnitchouk N, Kluth LA, Dasgupta P, Trinh QD