Long term treatment of venous thromboembolism is essential to complete therapy of the index episode and to
reduce recurrences. Vitamin K antagonists are the mainstay for the long term treatment of venous thromboembolism for
the majority of the patients as they allow oral administration. Low-molecular weight heparins are recommended for the
long term treatment of cancer patients. The duration of long term anticoagulation depends on the features of the index venous
thromboembolism and on the presence of associated risk factors. Patients at high risk for recurrence – mainly those
who suffered unprovoked venous thromboembolism and those with cancer – should be evaluated for extended anticoagulation.
The risk for major bleeding complications and the inconvenience for monitoring, dose adjustment and drug-food
interactions are the main constraints for indefinite anticoagulant treatment. New anticoagulants with more favourable efficacy-
safety profile and reduced need for monitoring could improve the feasibility of extended anticoagulation.
Keywords: Venous thromboembolism, vein thrombosis, pulmonary embolism, anticoagulants.
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