[Prophylaxis of recurrence during transient risk in patients with previous venous thromboembolism].

BACKGROUND

Current data allows first recommendations for the management of patients with previous venous thromboembolism (VTE) whose risk of recurrence is transiently increased.

METHODS

The literature about the risk of VTE recurrence in common clinical situations is analyzed, and recommendations for the diagnostic and therapeutic management and patient counseling are given.

CONCLUSIONS

Perioperative replacement of oral anticoagulants by low molecular weight heparins (LMWH) is effective and safe in patients treated for VTE. After a triggered first episode of VTE, the same prophylaxis in situations of transient risk is recommended as for patients without previous VTE. Patients with previous VTE who are pregnant or scheduled for hormonal therapy require a detailed exploration, as management is influenced by several factors. In the postpartal period, patients with previous VTE should receive prophylactic anticoagulation. In malignant disease, anticoagulation should be continued over the time of active malignancy; LMWH appear to have a more favorable profile than oral anticoagulants.