MONITORING OF HEPARIN IN THE DEEP VENOUS THROMBOSIS TREATMENT - AN OBSOLETE QUESTION

For over 25 years, it has been the rule to monitor heparin in this ind ication, mostly using the TCA (or AP-TT) test. The goal to be reached (APTT ratio), not yet definitly defined, results from multiplying an u ncertain baseline value (control APT) by a variable factor (greater th an or equal to 1.5 control value), these values being, in turn, determ ined using different reagents not providing uniform responses. With ti me, it has become clear that it was difficult to maintain the successi ve APTTs' within the therapeutic range and moreover, that a biological ly satisfying monitoring could not, by itself, prevents from complicat ions or clinical failures. Other classical methods experienced the sam e shortcommings. Low molecular weight heparin fractions have been prov ed to be easier to administer, since there is no need for biological m onitoring. Although persisting a still unresolved problem, heparin mon itoring in this indication appears to be, to date, an obsolete situati on and in the process of being circumvented.