Bemiparin and acenocoumarol home treatment for severe extensive recurrent DVT: should we still be dubious about it?

摘要

A 65 YO male, who had suffered Deep Venous Thrombosis (DVT) and Pulmonary Embolism (PE) 25 years before, was hospitalized in Soria, Spain, after 5 days of pain and swelling of the right calf; which worsened until swelling, redness, tenderness and pain extended throughout the whole right lower limb. A high probability DVT Wells score was found. No clinical signs or symptoms of PE were observed and CT scan excluded it. D-dimer test was 10.21 and venous ultrasonography confirmed the diagnosis of extensive DVT and thrombi from the popliteal up to the external iliac veins. Following our guideline, Bemiparin was immediately administer and was continued until optimal INR range was achieved acenocoumarol (4 days after being discharged home). Good outcome was observed over a 2 years follow up period. Despite the severity and magnitude of the DVT this patient did not develop PE with Bemiparin treatment, as he previously did with heparin.