[Internal medicine therapy of venous thromboembolism]

Treatment of venous thromboembolism aims at the reduction of mortality of massive pulmonary embolism, the arrest of further thrombotic processes and at avoiding late post-thrombotic sequelae. Anticoagulation with heparin and oral anticoagulants remains the treatment of choice. Heparin is administered intravenously or subcutaneously for four to five days. Oral anticoagulation follows thereafter for three to six months or even life-long. Low molecular weight heparin will probably be able to substitute for the unfractionated heparin in the initial treatment phase. Therapeutic fibrinolysis or surgical treatment are considered as alternative treatment modalities. Furthermore, new potent thrombin or platelet inhibitors appear as promising future antithrombotics.