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静脉血栓栓塞症管理国家指南:土耳其心血管外科学会、国家血管与血管内外科学会及静脉病学会联合指南

National guidelines on the management of venous thromboembolism: Joint guideline of the Turkish Society of Cardiovascular Surgery, National Society of Vascular and Endovascular Surgery, and Phlebology Society.

作者信息

Bozkurt Ahmet Kürşat, Akay Hakkı Tankut, Çalkavur İsmet Tanzer, Şırlak Mustafa, Balkanay Ozan Onur, Uğuz Emrah, Doğancı Suat, Polat Adil, Bayrak Serdar, Bozok Şahin, Durukan Ahmet Barış, Erdil Nevzat, Erer Dilek, Şenay Şahin, Ünal Ertekin Utku, Yavaş Soner

机构信息

Department of Cardiovascular Surgery, Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Istanbul, Turkey.

Department of Cardiovascular Surgery, Başkent University, Faculty of Medicine, Ankara, Turkey.

出版信息

Turk Gogus Kalp Damar Cerrahisi Derg. 2021 Oct 20;29(4):562-576. doi: 10.5606/tgkdc.dergisi.2021.22121. eCollection 2021 Oct.

Abstract

These evidence-based guidelines from the Turkish Society of Cardiovascular Surgery, National Society of Vascular and Endovascular Surgery, and Phlebology Society intend to support clinicians in best decisions regarding the treatment of venous thromboembolism (VTE). The Editor was selected by the three national societies and was tasked with the recruitment of the recognized panel. All financial support was solely derived from the sponsoring societies without the direct involvement of industry or other external stakeholders. The panel prioritized clinical questions and outcomes according to their importance for clinicians in terms of VTE. The panel agreed on 42 recommendations under 15 headings for the diagnosis, initial management, secondary prevention of VTE, and treatment of recurrent VTE events. Important recommendations included the use of ultrasonography, preference for home treatment over hospital treatment for uncomplicated VTE, preference for direct oral anticoagulants (DOACs) over vitamin K antagonists for primary treatment of cancer and non-cancer-related VTE, extended or indefinite anticoagulation with DOACs in selected high-risk patients. Early catheter-directed thrombectomy was recommended in only young symptomatic patients with a diagnosis of fresh iliofemoral deep vein thrombosis.

摘要

土耳其心血管外科学会、国家血管与血管内外科学会以及静脉病学会制定的这些循证指南旨在协助临床医生就静脉血栓栓塞症(VTE)的治疗做出最佳决策。编辑由这三个全国性学会选出,并负责招募知名专家小组。所有资金支持完全来自主办学会,无行业或其他外部利益相关方的直接参与。该专家小组根据对临床医生在VTE方面的重要性对临床问题和结果进行了优先排序。该专家小组就VTE的诊断、初始管理、二级预防以及复发性VTE事件的治疗等15个标题下的42项建议达成了一致。重要建议包括使用超声检查、对于无并发症的VTE,优先选择居家治疗而非住院治疗、对于癌症和非癌症相关VTE的初始治疗,优先选择直接口服抗凝剂(DOACs)而非维生素K拮抗剂、在选定的高危患者中使用DOACs进行延长或长期抗凝。仅建议对诊断为新鲜髂股深静脉血栓形成的年轻有症状患者进行早期导管直接血栓切除术。

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