Hard decisions in treatment of patients with venous thromboembolism and cancer

Abstract

Venous thromboembolism (VTE) is a frequent complication in cancer patients. Treatment of VTE in these patients in a big challenge, as the risk of thromboembolic complications as well as bleeding is further increased in cancer patients. We will present a few clinical situations that we often encounter in practice, when dilemma arises whether to administer anticoagulation therapy to a patient with VTE and cancer: recurrence of VTE despite treatment, thrombocytopenia, central nervous system tumors, use of inferior vena cava filters, use of new oral anticoagulation medications and accidentally discovered VTE.

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Povzetek

Venska trombembolija (VTE) je pogost zaplet pri bolnikih z rakom. Zdravljenje VTE pri teh bolnikih predstavlja velik izziv, saj je pri bolnikih z rakom dodatno povečano tako tveganje za trombembolične zaplete kot tudi tveganje za krvavitve. Predstavili bomo nekaj kliničnih situacij, s katerimi se v klinični praksi pogosto srečamo in predstavljajo dileme pri antikoagulacijskem zdravljenju bolnikov z VTE ter rakom, in sicer ponovitve VTE kljub zdravljenju, pojav trombocitopenije, tumorje osrednjega živčevja, uporabo filtrov v spodnji votli veni, uporabo novih peroralnih antikoagulacijskih zdravil in pojav naključno odkrite VTE.