Prevention of venous thromboembolism: heparins and other forms of prevention

Prevention of venous thromboembolism is of major importance because deep ve in thrombosis is an economic burden. To prevent pulmonary embolism, whether fatal or not, and the postphlebitic syndrome, virtually all patients' leve l of risk should be assessed in order to provide adequate prophylactic meas ures against venous thromboembolism. Non-pharmacological, pharmacological o r combined modalities can reduce the frequency of venous thrombosis. Eviden ce-based guidelines are available for most situations in surgical patients. However, in medical patients there are fewer data and there are wide varia tions of opinion. Systematic reviews should be performed and updated to obt ain practice guidelines. Cost and effectiveness as well as patients' prefer ences should be taken into account. Randomized control trials are ongoing: low-molecular-weight heparins are being evaluated in general medical patien ts; other forms of prophylaxis or combined methods are also being investiga ted.