[Preventive management of patients presenting with an increased tendency to venous thrombosis]

The thrombophilias are conditions characterized by an increased tendency to thrombosis. This paper aims at presenting the actual guidelines concerning the preventive attitudes in the thrombophilias that mainly expose to venous thromboembolism. The identification of these thrombophilias resides on one hand on the patients' and their family's history of venous thrombosis, and on the other hand on the diagnosis of disorders known to be associated with an increased risk of venous thrombosis. Heparin-associated thrombocytopenia of type II is a still too often underdiagnosed syndrome in which the prevention of thrombosis requires a specific approach. The authors discuss thoroughly the preventive attitudes for patients that do not require a long-term anticoagulation, for patients in whom a long-term anticoagulation is generally recommended, and for patients in whom it is sometimes recommended. The practical use of anticoagulation is described. Lastly, a special attention is paid to situations in which the thrombotic risk is increased, such as prolonged immobilization, surgery, traumas, pregnancy and postpartum, contraception and oestrogen therapy.