Controversies in VTOS: How Long Should Anticoagulation Be Used in VTOS?
Anticoagulation is an important element in the management of most patients with VTOS. The use of anticoagulation should be tailored to the specific form of VTOS present, however, and modified according to the condition of the individual patient. In general, patients with non-thormbotic positional venous compression requires no anticoagulation. Those with acute axillosubclavian vein thrombosis require anticoagulation to prevent propagation of thrombus, reduce the risk of pulmonary embolus, and to reduce the risk of rethrombosis while awaiting decompression, and following this should be anticoagulated for 3 months. Patients with chronic venous occlusion do not require anticoagulation for safety, but long-term anticoagulation may be associated with spontaneous recanalization and thus can be considered.