When is LMWH indicated for the treatment of venous thromboembolism (VTE)?

Updated: Nov 05, 2020
  • Author: Vera A De Palo, MD, MBA, FCCP; Chief Editor: Vinod K Panchbhavi, MD, FACS  more...
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Answer

Several studies have shown that LMWH, which is a fractionated heparin, is as effective as UFH in treating DVT. Minimal requirements for outpatient therapy with LMWH regimens include the following:

  • Stable PE or DVT
  • Low risk for bleeding
  • Absence of severe renal insufficiency
  • Availability of systems for administration and monitoring of LMWH and warfarin, as well as surveillance and treatment of recurrent thromboembolic disease

A Cochrane review found that LMWH, in a comparison with oral anticoagulants (eg, a vitamin K antagonist [VKA] or ximelagatran), reduced VTE events but not death in patients with cancer. [36]


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