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Phlebologie 2016; 45(04): 215-218
DOI: 10.12687/phleb2315-4-2016
DOI: 10.12687/phleb2315-4-2016
Review article
Venous thromboembolism in the elderly
Artikel in mehreren Sprachen: English | deutschAutoren
Weitere Informationen
Publikationsverlauf
Received:
08. Juni 2016
Accepted:
10. Juni 2016
Publikationsdatum:
21. Dezember 2017 (online)
Summary
Old age is an independent risk factor of venous thromboembolism. Nevertheless initial symptoms are often attributed to existing cardiac or pulmonary comorbidity. Once deep thromboembolism (DTE) is in focus, the synopsis of clinical findings and anamnestic clues help to take further steps to establish or rule out the diagnosis (e.g. Wells score). Treatment consists in oral anticoagulation, either by vitamin-k-antagonists or by direct oral anticoagulants (“DOACs”). Strict compliance of patients or main caregivers is essential in both cases. Simultaneous medication of platelet-inhibitingor nonsteroidal anti-inflammatory drugs – often unknown self medication – results in a raised bleeding risk and should be avoided. If longterm anticoagulation is mandatory, a strategy of sequential dose-reduced anticoagulation can be considered, especially in the case of increased bleeding-risk. Systemic fibrinolysis of pulmonary embolism goes along with a very high bleeding risk in old age and should be performed only in case of vital circulatory depression or failure.
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