Derin Ven Trombozunda Güncel Tedaviler

Venöz tromboembolizm, insan venöz dolaşımında görülen tüm patolojik trombozları kapsayan hastalık durumudur. En sık olarak alt ekstremite derin venlerinde (derin ven trombozu) görülür. Bununla birlikte, üst ekstremite, pelvis ve diğer vücut venlerinde de görülebilmektedir. Venöz tromboembolizmin yaşamı tehdit eden parçası ise pulmoner embolidir. Hasta mortalitesinin, morbiditesinin ve tekrarlayan olayların azaltılması için hızlı tanı ve optimum tedavi yaşamsaldır. Çoğu hastaya başlangıçta warfarine ek olarak fraksiyone olmayan heparin, düşük molekül ağırlıklı heparin veya fondaparinux tedavisinden birinin eklenmesi güncel kabul edilen tedavi şeklidir. Hastanın durumuna göre süresi oldukça değişken olabilecek warfarin tekli tedavisiyle uzun dönem tedavi devam ettirilir. Bu tedavi şeklinin önerildiği kılavuzlar yeni oral antikoagulanların onaylanmasından daha önce yayımlanmıştır. Yeni oral antikoagulanların kolay kullanımı, daha az takip edilme gereksinimleri ve muhtemelen varfarinden daha az bir kanama potansiyeline sahip olmaları başlıca avantajlarıdır. Bu derlemede yeni oral antikoagulanlar göz önünde bulundurularak derin ven trombozu güncel tedavisi sunulacaktır.

Anahtar Kelimeler:

Derin ven trombozu, Dabigatran, Apiksaban, Rivoraksaban, Varfarin

Current Treatmentsof Deep Venous Thrombosis

Venous thromboembolism is a disease spectrum that encompasses all pathologic thrombotic conditions observed in human venous system. It is most frequently seen in lower extremity deep veins where it is named as deep vein thrombosis. However, it might also be detected in upper extremity, pelvic and other venous systems of the body. Pulmonary embolism is the life-threatening component of venous thromboembolism. Rapid diagnosis and optimal treatment of are vital for decreasing patient mortality, morbidity, and the incidence of recurrent events. Initial treatment with unfractionated heparin, low-molecular weight heparin, or fondaparinux overlapped with warfarin is the currently approved treatment in most cases. Warfarin monotherapy is then continued for a time period which depends on the specific conditon of patients. These current treatment guidelines were published before the approval of new oral anticoagulants. The advantages of new oral anticoagulants are the ease of use, reduced monitoring requirements, and probably lower bleeding risk than warfarin therapy. This review addresses the current treatment of venous thromboembolism, with a particular emphasis on new oral anticoagulants.

Keywords:

Deep vein thrombosis, Dabigatran, Apixaban, Rivoraxaban, Warfarin,

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