Perspectives in Vascular Surgery 2000; Volume 13(Number 3): 0019-0026
DOI: 10.1055/s-2000-9515
Copyright © 2000 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel. +1(212)584-4662.

The Safety, Efficacy, and Cost Efficiency of Outpatient Treatment of Acute Deep Venous Thrombosis with Low Molecular Weight Heparin

Thomas W. Wakefield
  • Professor of Surgery, Section of Vascular Surgery, Department of Surgery, University of Michigan, and Ann Arbor Veterans Administration Medical Center, Ann Arbor, MI.
Further Information

Publication History

Publication Date:
31 December 2000 (online)


-Deep venous thrombosis (DVT) and pulmonary embolism (PE) remain significant heath care problems. Although standard unfractionated heparin effectively treats DVT and PE, low molecular weight heparins (LMWHs) have many theoretical advantages, including less bleeding potential, less thrombocytopenia, improved bioavailability, and more even pharmacokinetics. Additionally, LMWHs are given subcutaneously based on patient weight and do not need to be monitored by blood tests. Multiple studies have compared LMWH to standard heparin for treatment of DVT/PE. LMWHs have a lower risk for major bleeding, recurrent thromboembolic disease, and mortality rate for the treatment of DVT, whereas for PE treatment they are at least equivalent to standard heparin and more convenient. However, not all patients are candidates for such outpatient therapy. The ability to give LMWH subcutaneously and the lack of need for intensive blood monitoring allows for outpatient therapy.