Anticoagulation Therapy for Venous Thromboembolism.

Anjum, Phillip; Utz, Alyssa; Kimbrell, Michael; Akbashev, Mikhail · Med Clin North Am · 2025

Level V

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Abstract

Anticoagulation in venous thromboembolism (VTE) management requires a tailored approach that balances the risk of recurrence with the potential for bleeding complications. Direct oral anticoagulants have become the preferred initial therapy for most patients due to their ease of use and superior safety profile compared to vitamin K antagonists. Special considerations, however, are necessary for certain populations. Patients with renal impairment, cancer, or recurrent VTE may require alternative therapies or extended anticoagulation. Emerging anticoagulants targeting factor XI and XII show promise in reducing bleeding risk while preventing thrombosis.

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