{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T03:20:24Z","timestamp":1788232824677,"version":"build-2803163510"},"reference-count":100,"publisher":"American Society of Hematology","issue":"5","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,1,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>All patients with venous thromboembolism (VTE) should receive anticoagulant treatment in the absence of absolute contraindications. Initial anticoagulant treatment is crucial for reducing mortality, preventing early recurrences, and improving long-term outcome. Treatment and patient disposition should be tailored to the severity of clinical presentation, to comorbidities, and to the potential to receive appropriate care in the outpatient setting. Direct oral anticoagulants (DOACs) used in fixed doses without laboratory monitoring are the agents of choice for the treatment of acute VTE in the majority of patients. In comparison with conventional anticoagulation (parenteral anticoagulants followed by vitamin K antagonists), these agents showed improved safety (relative risk [RR] of major bleeding, 0.61; 95% confidence interval [CI], 0.45-0.83) with a similar risk of recurrence (RR, 0.90; 95% CI, 0.77-1.06). Vitamin K antagonists or low molecular weight heparins are still alternatives to DOACs for the treatment of VTE in specific patient categories such as those with severe renal failure or antiphospholipid syndrome, or cancer, respectively. In addition to therapeutic anticoagulation, probably less than 10% of patients require reperfusion by thrombolysis or interventional treatments; those patients are hemodynamically unstable with acute pulmonary embolism, and a minority of them have proximal limb-threatening deep vein thrombosis (DVT). The choice of treatment should be driven by the combination of evidence from clinical trials and by local expertise. The majority of patients with acute DVT and a proportion of selected hemodynamically stable patients with acute pulmonary embolism can be safely managed as outpatients.<\/jats:p>","DOI":"10.1182\/blood.2019001881","type":"journal-article","created":{"date-parts":[[2020,1,9]],"date-time":"2020-01-09T14:49:50Z","timestamp":1578581390000},"page":"305-316","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":47,"title":["Acute treatment of venous thromboembolism"],"prefix":"10.1182","volume":"135","author":[{"given":"Cecilia","family":"Becattini","sequence":"first","affiliation":[{"name":"Internal and Cardiovascular Medicine\u2013Stroke Unit, University of Perugia, Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giancarlo","family":"Agnelli","sequence":"additional","affiliation":[{"name":"Internal and Cardiovascular Medicine\u2013Stroke Unit, University of Perugia, Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"234","reference":[{"issue":"2","key":"2020013012000298000_B1","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1160\/TH16-07-0509","article-title":"Reasons for the persistent incidence of venous thromboembolism","volume":"117","author":"Heit","year":"2017","journal-title":"Thromb Haemost"},{"issue":"2","key":"2020013012000298000_B2","first-page":"255","article-title":"Epidemiology of first and recurrent venous thromboembolism: a population-based cohort study in patients without active cancer","volume":"112","author":"Martinez","year":"2014","journal-title":"Thromb Haemost"},{"issue":"9","key":"2020013012000298000_B3","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1016\/j.amjmed.2014.03.041","article-title":"Secular trends in occurrence of acute venous thromboembolism: the Worcester VTE study (1985-2009)","volume":"127","author":"Huang","year":"2014","journal-title":"Am J Med"},{"issue":"1","key":"2020013012000298000_B4","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s11239-015-1311-6","article-title":"The epidemiology of venous thromboembolism","volume":"41","author":"Heit","year":"2016","journal-title":"J Thromb Thrombolysis"},{"issue":"9","key":"2020013012000298000_B5","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1001\/archinternmed.2011.178","article-title":"Time trends in pulmonary embolism in the United States: evidence of overdiagnosis","volume":"171","author":"Wiener","year":"2011","journal-title":"Arch Intern Med"},{"issue":"7138","key":"2020013012000298000_B6","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1016\/S0140-6736(60)92299-6","article-title":"Anticoagulant drugs in the treatment of pulmonary embolism. 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