[Therapy of thrombosis with conventional heparin]

The use of heparins is established in the treatment of recent deep vein thrombosis, when contraindications for thrombectomy or thrombolytic therapy are present. Recent data indicate that twice daily subcutaneous administration of unfractionated heparin is almost as effective and safe as the continuous intravenous infusion. Detailed analysis of the randomized prospective and phlebographic controlled studies indicate that the subcutaneous administration is even somewhat more effective and especially safer. The higher safety refers to a lower incidence of moderate and severe bleeding complications as well as to local infections due to the continuous intravenous infusion. The phlebographic investigations demonstrate that the Marder Score is improved in 50-60% of heparinized patients. Complete thrombolysis is obtained in about 10% of patients. These results are better than those reported between 1950 and 1969. It is concluded that heparins exert some thrombolytic effects in recent deep vein thrombosis and that subcutaneous administration is almost as effective and safe as intravenous continuous infusion.