Conservative treatment of acute deep vein thrombosis of the lower extremity

During the acute phase of the disease the aim of conservative treatment of DVT is relief of symptoms as well as prevention of thrombus progression and pulmonary embolism. In the chronic phase treatment should prevent recurren ce and postthrombotic syndrome. Besides general measures such as compressio n therapy, elevation of the leg and mobilisation anticoagulation therapy wi th heparin and coumarin has been proved to be successful. Even though not m ore effective or safer low-molecular weight heparin has recently replaced u nfractionated heparin in the initial treatment of DVT mainly because of its more convenient use allowing modem ambulatory and outdoor treatment. Doses depend on the kind of heparin used. In the secondary prevention therapy wi th coumarins, an WR of 2-3 is generally accepted whereas the duration of or al anticoagulant therapy is under discussion. Compression therapy is recomm ended for at least 2 years, in case of postthrombotic syndrome life-long th erapy is necessary. When comparing the effectivness of DVT-treatment today with the results in the preanticoagulant era, the modern treatment is more effective, safe and cost-effective; it also guarantees more quality of life , but the long-term results have to be improved.