By American College of Chest Physicians
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Therefore, in the absence of a high bleeding risk, most patients with an unprovoked event should receive indefinite therapy. There is no evidence that longer (but finite) initial courses of therapy (such as 6, 12, or 18 months) are more effective than 3 months because the recurrence rates upon discontinuation of therapy are identical. In patients with continuing risk factors (such as active malignancy) and patients who have had a documented recurrent event, long-term (perhaps lifelong) therapy is recommended.
Galie N, Rubin LJ, eds. Pulmonary arterial hypertension: epidemiology, pathobiology, assessment, and therapy. indd 34 This entire supplement is devoted to PH, with articles by noted authorities. Geerts WH, Bergqvist D, Pineo GF, et al. Prevention of venous thromboembolism. American College of Chest Physicians evidence-based clinical practice guidelines. 8th ed. Chest 2008; 133:381S−453S Evidence-based recommendations on prevention of VTE in all surgical and medical populations. Excellent review of the literature on risk, risk stratification, and preventive strategies.
Moores LK, Holley AB. Computed tomography pulmonary angiography and venography: diagnostic and prognostic properties. Semin Respir Crit Care Med 2008; 29:3−14 An up-to-date review of the diagnostic accuracy and utility, as well as the prognostic features, of spiral CT angiography and venography. Moores LK, Jackson WL Jr, Shorr AF, et al. indd 35 embolism managed with computed tomographic pulmonary angiography. Ann Intern Med 2004; 141:866−874 The rate of subsequent VTE after negative results of spiral CTPA is similar to that seen after negative results on conventional pulmonary angiography.