Outpatient Therapy of Deep Vein Thrombosis

The initial treatment of acute venous thrombosis using low-molecular-weight heparin (LMWH) in the outpatient setting has been shown to be feasible, effective, and safe for selected patients when compared with in-hospital treatment using continuous intravenous heparin. There will always be a significant population of patients, however, who require in-hospital treatment with either LMWH or unfractionated heparin. It is clear that substantial cost savings can be achieved with the out-of-hospital treatment of venous thrombosis, but several logistic problems require solutions before these savings can be realized. Numerous strategies, including the development of anticoagulation management clinics, are under review, especially for the management of arterial or venous thrombosis with LMWH. It is likely that the outpatient management of venous thrombosis will vary, depending on the referral base of the institution involved.