Why the study?
Does dual anticoagulant therapy combined with an IVC filter prevent further VTE in cancer patients with recurrent VTE despite standard therapeutic anticoagulation?
Does dual anticoagulant therapy combined with an IVC filter prevent further VTE in cancer patients with recurrent VTE despite standard therapeutic anticoagulation?
A novel strategy of dual anticoagulation (twice-daily dalteparin plus warfarin) with an IVC filter may prevent further events in cancer patients with recurrent VTE failing standard anticoagulation.
May warrant consideration in refractory cancer-associated VTE; leaves open need for prospective validation.
Recurrent venous thromboembolism (VTE) occurs frequently in cancer patients, yet there is little published literature to guide clinicians in the management of these patients who are already receiving therapeutic anticoagulation. We report two patients with progressive solid malignancies who presented with recurrent VTE despite therapeutic anticoagulation with once-daily dalteparin. We describe how a novel aggressive strategy using a combination of therapeutic dalteparin twice daily and a vitamin K antagonist (warfarin) prevented further VTE.
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Pillai et al. (2010) studied this question.
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