Interdisziplinäre S2-Leitlinie

Leitlinien sind systematisch erarbeitete Empfehlungen, um Kliniker und Praktiker bei Entscheidungen über die angemessene Patientenversorgung im Rahmen spezifischer klinischer Umstände zu unterstützen. Leitlinien gelten für so genannte Standard-situationen. Sie berücksichtigen aktuelle, zu den entsprechenden Fragestellungen verfüg-bare wissenschaftliche Erkenntnisse.

Leitlinien bedürfen einer ständigen Überprüfung und eventuell der Änderung auf Basis des wissenschaftlichen Erkenntnisstandes und der Praktikabilität in der täglichen Praxis. Durch die Leitlinien soll die ärztliche Methodenfreiheit nicht eingeschränkt werden. Ihre Beachtung garantiert nicht in jedem Fall den diagnostischen und therapeutischen Erfolg. Leitlinien erheben keinen Anspruch auf Vollständigkeit. Die Entschei-dung über die Angemessenheit der zu ergreifenden Maßnahmen trifft der Arzt oder die Ärztin unter Berücksichtigung der individuellen Problematik.

• Literatur

• 1 Anderson DR, Kovacs MJ, Kovacs G. et al. Combined use of clinical assessment and D-dimer to improve the management of patients presenting to the emergency department with suspected deep vein thrombosis (the EDITED Study). Thromb Haemost 2003; 1: 645-51.
• 2 Arcasoy SM, Vachani A. Local and systemic thrombolytic therapy for acute venous thromboembolism. Clin Chest Med 2003; 24: 73-91.
• 3 Arzneimittelkommission der deutschen Ärzteschaft.. Bekanntgabe zur Heparin-induzierten Thrombozytopenie. Dt Ärzteblatt 1999 96 (Heft 6)
• 4 Aschwanden M, Labs KH, Engel H. et al. Acute deep vein thrombosis: early mobilization does not increase the frequency of pulmonary embolism. Thromb Haemost 2001; 85: 42-6.
• 5 Baglin T, Luddington R, Brown K. et al. Incidence of recurrent venous thromboembolism in relation to clinical and thrombophilic risk factors: prospective cohort study. Lancet 2003; 362: 523-6.
• 6 Baldwin ZK, Comerota AJ, Schwartz LB. Catheter-directed thrombolysis for deep venous thrombosis. Vasc Endovascular Surg 2004; 38: 1-9.
• 7 Barritt DW, Jordan SC. Anticoagulant drugs in the treatment of pulmonary embolism. Lancet 1960: 1309-12.
• 8 Bates SM, Kearon C, Crowther M. et al. A Diagnostic Strategy Involving a Quantitative Latex D-Dimer Assay Reliably Excludes Deep Venous Thrombosis. Ann Intern Med 2003; 138: 787-94.
• 9 Beer JH, Burger M, Gretener S. et al. Out-patient treatment of pulmonary embolism is feasible and safe in a substantial proportion of patients. J Thromb Haemost 2003; 1: 186-7.
• 10 Bernardi E, Prandoni P, Lensing AWA. et al. D-dimer testing as an adjunct to ultrasonography in patients with clinically suspected deep vein thrombosis: prospective cohort study. Br Med J 1998; 317: 1037-40.
• 11 Bertina RM. Molecular risk factors for thrombosis. Thromb Haemost 1999; 82: 601-9.
• 12 Blättler W, Heller G, Largiadèr J. et al. Combined regional thrombolysis and surgical thrombectomy for treatment of iliofemoral vein thrombosis. J Vasc Surg 2004; 40: 620-5.
• 13 Blättler W, Martinez I, Blättler IK. Diagnosis of deep venous thrombosis and alternative diseases in symptomatic outpatients. Eur J Intern Med 2004; 15: 305-11.
• 14 Blevins S, Edwards S, Raskob G. Helical computed tomography and magnet resonance imaging: diagnosis of pulmonary embolism in symptomatic patients. Curr Opin Hematol 2003; 10: 345-50.
• 15 Brandjes DPM, Büller HR, Heijboer H. et al. Randomized trial of effect of compression stockings in patients with symptomatic proximal-vein thrombosis. Lancet 1997; 349: 759-62.
• 16 Brill-Edwards P, Ginsberg JS, Gent M. et al. Safety of withholding heparin in pregnant women with a history of venous thromboembolism. Recurrence of Clot in This Pregnancy Study Group. N Engl J Med 2000; 343: 1439-44.
• 17 British Thoracic Society Standards of Care Committee Pulmonary Embolism Guideline Development Group.. British Thoracic Society Guidelines for the management of suspected acute pulmonary embolism. Thorax 2003; 58: 470-84.
• 18 Büller HR, Agnelli G, Hull RD. et al. Anti-thrombotic therapy for venous thromboembolic disease. The Seventh ADDP Conference on Antithrombotic and Thrombotic Therapy. Chest 2004; 126: 401S-28.
• 19 Büller HR, Davidson BL, Decousus H. et al. Fondaparinux or enoxaparin for the initial treatment of symptomatic deep venous thrombosis. Ann Intern Med 2004; 140: 867-73.
• 20 Büller HR, Davidson BL, Decousus H. et al. Subcutaneous fondaparinux versus intravenous unfractionated heparin in the initial treatment of pulmonary embolism. N Engl J Med 2003; 348: 1695-702.
• 21 Büller HR, Prins MH. Secondary prophylaxis with warfarin for venous thromboembolism. N Engl J Med 2003; 349: 702-4.
• 22 Bundesärztekammer.. Richtlinienerfassung zur Krebsfrüherkennung. Änderungsbeschluss vom 04.10.2002. Dt Ärzteblatt 2002 99. A 706-8.
• 23 Cogo A, Lensing AWA, Koopman MMW. et al. Compression ultrasonography for diagnostic management of patients with clinically suspected deep vein thrombosis: prospective cohort study. Br Med J 1998; 316: 17-20.
• 24 Cornuz J, Ghali WA, Hayoz D. et al. Clinical prediction of deep venous thrombosis using two risk assessment methods in combination with rapid quantitative D-dimer testing. Am J Med 2002; 112: 198-203.
• 25 Cueto SM, Cavanaugh SH, Benenson RS. et al. Computed tomography scan versus ventilation-perfusion lung scan in the detection of pulmonary embolism. J Emerg Med 2001; 21: 155-64.
• 26 Dalen JE, Alpert JS, Hirsh J. Thrombolytic therapy for pulmonary embolism: is it effective?. Is it safe? When is it indicated? Arch Intern Med 1997; 157: 2550-6.
• 27 Decousus H, Epinat M, Guillot K. et al. A: Superficial vein thrombosis: risk factors, diagnosis, and treatment. Curr Pulm Med 2003; 9: 393-7.
• 28 Decousus H, Leizorovicz A, Parent F. et al. A clinical trial of vena caval filters in the prevention of pulmonary embolism in patients with proximal deep-vein thrombosis. Prevention du Risque d’Embolie Pulmonaire par Interruption Cave Study Group. N Engl J Med 1998; 338: 409-15.
• 29 DGA.. Leitlinien zur Diagnostik und Therapie der Venenthrombose und Lungenembolie. VASA 2002; 31 Suppl 60.
• 30 DGP.. Leitlinie zur Diagnostik und Therapie der tiefen Bein- und Beckenvenenthrombose. Phlebologie 2003; 6: 157-64.
• 31 Eklof B, Arfvidsson B, Kistner RL. et al. A: Indications for surgical treatment of iliofemoral vein thrombosis. Hematol Oncol Clin North Am 2000; 14: 471-82.
• 32 Elias A, Mallard L, Elias M. et al. A single complete ultrasound investigation of the venous network for the diagnostic management of patient with a clinically suspected first episode of deep venous thrombosis of the lower limbs. Thromb Haemost 2003; 89: 221-7.
• 33 Eriksson H, Wahlander K, Gustafsson D. et al. A randomized, controlled, dose-guiding study of the oral direct thrombin inhibitor ximelagatran compared with standard therapy for the treatment of acute deep vein thrombosis: THRIVE I. J Thromb Haemost 2003; 1: 41-7.
• 34 Fattorini A, Crippa L, Vigano D, Angelo S. et al. Risk of deep vein thrombosis recurrence: high negative predictive value of D-dimer performed during oral anticoagulation. Thromb Haemost 2002; 88: 162-3.
• 35 Gerhardt A, Scharf RE, Beckmann MW. et al. Prothrombin and factor V mutations in women with a history of thrombosis during pregnancy and the puerperium. N Engl J Med 2000; 342: 374-80.
• 36 Gerlach HE, Blättler W. Kontrollierte Einführung der ambulanten Behandllung der akuten tiefen Beinvenenthrombose: Mach-barkeitsstudie an 827 Patienten. Phlebologie 2002; 31: 77-84.
• 37 Ghaye B, Szapiro D, Mastora I. et al. Peripheral pulmonary arteries: how far in the lung does multi-detector row spiral CT allow analysis?. Radiology 2001; 219: 629-36.
• 38 Giannitsis E, Muller-Bardorff M, Kurowski V. et al. Independent prognostic value of cardiac troponin T in patients with confirmed pulmonary embolism. Circulation 2000; 102: 211-7.
• 39 Ginsberg JS, Bates SM. Management of venous thromboembolism during pregnancy. J Thromb Haemost 2003; 1: 1435-42.
• 40 Goldhaber SZ. A clinical overview of venous thromboembolism. Vasc Med 1998; 3: 35-40.
• 41 Goldhaber SZ. Pulmonary embolism. N Engl J Med 1998; 339: 93-104.
• 42 Goldhaber SZ. Echocardiography in the management of pulmonary embolism. Ann Intern Med 2002; 136: 691-700.
• 43 Gottlieb RH, Voci SL, Syed L. et al. Randomized prospective study comparing routine versus selective use of sonography of the complete calf in patients with suspected deep venous thrombosis. Am J Roentgenol 2003; 180: 241-5.
• 44 Grifoni S, Olivotto I, Cecchini P. et al. Short-term clinical outcome of patients with acute pulmonary embolism, normal blood pressure, and echocardiographic right ventricular dys-function. Circulation 2000; 101: 2817-22.
• 45 Gulba DC, Schmid C, Borst HG. et al. Medical compared with surgical treatment for massive pulmonary embolism. Lancet 1994; 343: 576-7.
• 46 Hach W, Hach-Wunderle V. Phlebography and sonography of the veins. Berlin, Heidelberg: Springer; 1997
• 47 Hach W, Hach-Wunderle V. Die phlebographische Untersuchung der Soleus- und Gastrocnemiusvenen. Gefäßchirurgie 2002; 7: 31-8.
• 48 Hach W, Hach-Wunderle V, Präve F. Wie lassen sich die Phlebogramme verbessern?. Gefäßchirurgie 2003; 8: 55-62.
• 49 Heilmann L, Rath W, von Tempelhoff GF. et al. Niedermolekulare Heparine in der Schwangerschaft. Dt Ärzteblatt 2002; 99: A424-32.
• 50 Hirsh J, Dalen JE, Anderson DR. et al. Oral anticoagulants: Mechanism of action, clinical effectiveness, and optimal therapeutic range. Chest 2001; 119: 8S-21.
• 51 Hull R, Hirsh J, Sackett DL. et al. Clinical validity of a negative venogram in patients with clinically suspected venous thrombosis. Circulation 1981; 64: 622-5.
• 52 Hull RD, Raskob GE, Brant RF. et al. The importance of initial heparin treatment on long-term clinical outcomes of antithrombotic therapy. The emerging theme of delayed recurrence. Arch Intern Med 1997; 157: 2317-21.
• 53 Hutten BA, Prins MH. Duration of treatment with vitamin K antagonists in symptomatic venous thromboembolism (Cochrane Review). The Cochrane Library; 2004. issue 4.
• 54 Iorio A, Guercini F, Pini M. Low-molecular-weight heparin for the long-term treatment of symptomatic venous thromboembolism: meta-analysis of the randomized comparisons with oral anticoagulants. J Thromb Haemost 2002; 1: 1906-13.
• 55 Jamieson SW, Kapelanski DP. Pulmonary endarterectomy. Curr Probl Surg 2000; 37: 165-252.
• 56 Kanne JP, Lanani TA. Role of computed tomography and magnetic resonance imaging for deep venous thrombosis and pulmonary embolism. Circulation 2004; 109: I15-21.
• 57 Kasper W, Geibel A, Tiede N. et al. Distinguishing between acute and subacute massive pulmonary embolism by conventional and Doppler echocardiography. Br Heart J 1993; 70: 352-6.
• 58 Kasper W, Konstantinides S, Geibel A. et al. Management strategies and determinants of outcome in acute major pulmonary embolism: results of a multicenter registry. J Am Coll Cardiol 1997; 30: 1165-71.
• 59 Kasper W, Konstantinides S, Geibel A. et al. Prognostic significance of right ventricular afterload stress detected by echocardiography in patients with clinically suspected pulmonary embolism. Heart 1997; 77: 346-9.
• 60 Katz DS, Loud PA, Bruce D. et al. Combined CT venography and pulmonary angiography: a comprehensive review. Radiographics 2002; 22: 3-24.
• 61 Kearon C. Natural history of venous thromboembolism. Circulation 2003; 107: I22-30.
• 62 Kearon C, Gent M, Hirsh J. et al. A comparison of three months of anticoagulation with extended anticoagulation for a first episode of idiopathic venous thromboembolism. N Engl J Med 1999; 340: 901-7.
• 63 Konstantinides S, Geibe A, Olschewski M. et al. Importance of cardiac troponins I and T in risk stratification of patients with acute pulmonary embolism. Circulation 2002; 106: 1263-8.
• 64 Koopman MMW, Prandoni P, Piovella F. et al. Treatment of venous thrombosis with intravenous unfractionated heparin administered in the hospital as compared with subcutaneous low-molecular-weight heparin administered at home. N Engl J Med 1996; 334: 682-7.
• 65 Kruip MJHA, Leclercq MGL, van der Heul C. et al. Diagnostic strategies for excluding pulmonary embolism in clinical outcome studies. Ann Intern Med 2003; 138: 941-51.
• 66 Kucher N, Printzen G, Doernhoefer T. et al. Low pro-brain natriuretic peptide levels predict benign clinical outcome in acute pulmonary embolism. Circulation 2003; 107: 1576-8.
• 67 Kurkciyan II, Sterz F, Meron G. et al. Thrombolysis and pulmonary embolism presenting with cardiac arrest. Arch Intern Med 2000; 160: 3496-7.
• 68 Largiadèr J, Blättler W, Gloor B. Therapeutic concept for acute leg and pelvic venous thrombosis. Acta Chir Belg 2002; 102: 356-61.
• 69 Lee AYY, Levine MN, Baker RI. et al. Low-molecular-weight heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer. N Engl J Med 2003; 349: 146-53.
• 70 Lensing AW, Prins MH, Falanga A. et al. Extensive screening for occult malignant disease in idiopathic venous thromboembolism: a prospective randomized clinical trial. J Thromb Haemost 2004; 2: 884-9.
• 71 Levine M, Gent M, Hirsh J. et al. A comparison of low-molecular-weight heparin administered primarily at home with unfractionated heparin administered in the hospital for proximal deep-vein thrombosis. N Engl J Med 1996; 334: 677-81.
• 72 Lualdi JC, Goldhaber SZ. Right ventricular dysfunction after acute pulmonary embolism: pathophysiologic factors, detection, and therapeutic implications. Am Heart J 1995; 130: 1276-82.
• 73 Mayer E, Dahm M, Hake U. et al. Mid-term results of pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension. Ann Thorac Surg 1996; 61: 1788-92.
• 74 Meyer G, Marjanovic Z, Valcke J. et al. Comparison of low-molecular-weight heparin and warfarin for the secondary prevention of venous thromboembolism in patients with cancer: a randomized controlled study. Arch Intern Med 2002; 162: 1729-35.
• 75 Middeldorp S, Meinardi JR, Koopman MMW. et al. A prospective study of asymptomatic carriers of the factor V Leiden mutation to determine the incidence of venous thromboembolism. Ann Intern Med 2001; 135: 322-7.
• 76 Mills TD, Chan O, Matson M. The use of vena caval filters. Hosp Med 2001; 62: 327-31.
• 77 Miniati M, Prediletto R, Formichi B. et al. Accuracy of clinical assessment in the diagnosis of pulmonary embolism. Am J Respir Crit Care Med 1999; 159: 864-71.
• 78 Monreal M, Lensing AW, Prins MH. et al. Screening for occult cancer in patients with acute deep vein thrombosis or pulmonary embolism. J Thromb Haemost 2004; 2: 876-81.
• 79 Moser KM, Daily PO, Peterson K. et al. Thromboendarterectomy for chronic, major-vessel thromboembolic pulmonary hypertension. Immediate and long-term results in 42 patients. Ann Intern Med 1987; 107: 560-5.
• 80 Mousa SA, Mohamed S. Antiangiogenic mechanisms and efficacy of the low molecular weight heparin, tinzaparin: anti-cancer efficacy. Oncol Rep 2004; 12: 683-8.
• 81 Musset D, Parent F, Meyer G. et al. Diagnostic strategy for patients with suspected pulmonary embolism: a prospective multicentre outcome study. Lancet 2002; 360: 1914-20.
• 82 Nettelbladt E, Wuppermann T. Klinische Untersuchungen der tiefen Beinvenenthrombose. In: Wuppermann T, Richter A. (Hrsg). Thrombose und Thrombosefolgen. Konstanz: Schnetztor; 1991
• 83 Nilsson T, Mare K, Carlsson A. Value of structured clinical and scintigraphic protocols in acute pulmonary embolism. J Intern Med 2001; 250: 213-8.
• 84 O’Meara Jr, McNutt RA, Evans AT. et al. A decision analysis of streptokinase plus heparin as compared with heparin alone for deep-vein thrombosis. N Engl J Med 1994; 330: 1895-6.
• 85 Palareti G, Legnani C, Cosmi B. et al. Risk of venous thromboembolism recurrence: high negative value of D-dimer performed after oral anticoagulation is stopped. Thromb Haemost 2002; 87: 7-12.
• 86 Partsch H, Blättler W. Compression and walking versus bed rest in the treatment of proximal deep venous thrombosis with low molecular weight heparin. J Vasc Surg 2000; 32: 861-9.
• 87 Pengo V, Lensing AW, Prins MH. et al. Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism. N Engl J Med 2004; 350: 2257-64.
• 88 Perkins JM, Magee TR, Galland RB. Phlegmasia caerulea dolens and venous gangrene. Br J Surg 1996; 83: 19-23.
• 89 Perrier A, Desmarais S, Miron J. et al. Non-invasive diagnosis of venous thromboembolism in outpatients. Lancet 1999; 353: 190-5.
• 90 Perrier A, Howarth N, Didier D. et al. Performance of helical computed tomography in unselected outpatients with suspected pulmonary embolism. Ann Intern Med 2001; 135: 88-97.
• 91 Perrier A, Roy PM, Aujesky D. et al. Diagnosing pulmonary embolism in outpatients with clinical assessment, D-dimer measurement, venous ultrasound, and helical computed tomography: a multicenter management study. Am J Med 2004; 116: 291-9.
• 92 Pillny M, Sandmann W, Luther B. et al. Deep venous thrombosis during pregnancy and after delivery: indications for and results of thrombectomy. J Vasc Surg 2003; 37: 528-32.
• 93 Pinede L, Duhaut P, Cucherat M. et al. Comparison of long versus short duration of anticoagulant therapy after a first episode of venous thromboembolism: a meta-analysis of randomized, controlled trials. J Intern Med 2000; 247: 553-62.
• 94 Plate G, Eklof B, Norgren L. et al. Venous thrombectomy for iliofemoral vein thrombosis: 10-year results of a prospective randomised study. Eur J Vasc Endovasc Surg 1997; 14: 367-74.
• 95 Prandoni P, Lensing AW, Bernardi E. et al. The diagnostic value of compression ultrasonography in patients with suspected recurrent deep vein thrombosis. Thromb Haemost 2002; 88: 402-6.
• 96 Prandoni P, Lensing AW, Prins MH. et al. Below-knee elastic compression stockings to prevent the post-thrombotic syndrome: a randomized, controlled trial. Ann Intern Med 2004; 141: 249-56.
• 97 Prins MH, Hutten BA, Koopman MMW. et al. Long-term treatment of venous thromboembolic disease. Thromb Haemost 1999; 82: 892-8.
• 98 Prologo JD, Glauser J. Variable diagnostic approach to suspected pulmonary embolism in the ED of a major academic tertiary care center. Am J Emerg Med 2002; 20: 5-9.
• 99 Pruszczyk P, Kostrubiec M, Bochowicz A. et al. N-terminal pro-brain natriuretic peptide in patients with acute pulmonary embolism. Eur Respir J 2003; 22: 649-53.
• 100 Raptopoulos V, Boiselle PM. Multi-detector row spiral CT pulmonary angiography: comparison with single-detector row spiral CT. Radiology 2001; 221: 606-13.
• 101 Rath W, Heilmann L. Thrombophile Risikofaktoren und Schwangerschaftskomplikationen. Frauenarzt 2002; 43: 537-46.
• 102 Reekers JA, Baarslag HJ, Koolen MG. et al. Mechanical thrombectomy for early treatment of massive pulmonary embolism. Cardiovasc Intervent Radiol 2003; 26: 246-50.
• 103 Reissig A, Kroegel C. Therapeutic approaches to acute pulmonary embolism. Internist 2004; 45: 540-8.
• 104 Ridker PM, Goldhaber SZ, Danielson E. et al. Long-term, low-intensity warfarin therapy for the prevention of recurrent venous thromboembolism. N Engl J Med 2003; 348: 1425-34.
• 105 Schellong SM, Schwarz T, Halbritter K. et al. Complete compression ultrasonography of the leg veins as a single test for the diagnosis of deep vein thrombosis. Thromb Haemost 2003; 89: 228-34.
• 106 Schellong SM, Schwarz T, Kropp J. et al. Bed rest in deep vein thrombosis and the incidence of scintigraphic pulmonary embolism. Thromb Haemost 1999; 82: 127-9.
• 107 Schoepf UJ, Holzknecht N, Helmberger TK. et al. Subsegmental pulmonary emboli: improved detection with thin-collimation multi-detector row spiral CT. Radiology 2002; 222: 483-90.
• 108 Schulman S, Wählander K, Lundström T. et al. Secondary prevention of venous thromboembolism with the oral direct thrombin inhibitor ximelagatran. N Engl J Med 2003; 349: 1713-21.
• 109 Schutgens REG, Ackermark P, Haas FJLM. et al. Combination of a normal D-dimer concentration and a non-high pretest clinical probability score is a safe strategy to exclude deep venous thrombosis. Circulation 2003; 107: 593-7.
• 110 Schwarz T, Romahn K, Schellong SM. The value of compression ultrasound of the calf veins in patients with acute pulmonary embolism. Haemostaseologie 2004; 24: A63.
• 111 Schwarz T, Schmidt B, Höhlein U. et al. Eligibility for home treatment of deep vein thrombosis: prospective study. Br Med J 2001; 322: 1212-3.
• 112 Simmoneau G, Sors H, Charbonnier B. A comparison of low-molecular-weight heparin with unfractionated heparin for acute pulmonary embolism. N Engl J Med 1997; 337: 663-9.
• 113 Stein PD, Henry JW. Prevalence of acute pulmonary embolism among patients in a general hospital and at autopsy. Chest 1995; 108: 978-81.
• 114 Stein PD, Hull RD, Patel KD. et al. D-dimer for the exclusion of acute venous thrombosis and pulmonary embolism. Ann Intern Med 2004; 140: 589-602.
• 115 Tack D, De Maertelaer V, Gevenois PA. Dose reduction in multidetector CT using attenuation-based online tube current modulation. Am J Roentgenol 2003; 181: 331-4.
• 116 Tapson VF, Witty LA. Massive pulmonary embolism. Diagnostic and therapeutic strategies. Clin Chest Med 1995; 16: 329-40.
• 117 The PIOPED Investigators.. Value of perfusion lung scan in the diagnosis of pulmonary embolism: results of the prospective study of acute pulmonary diagnosis. Am J Respir Crit Care Med 1996; 154: 1387-93.
• 118 Tutschek B, Struve S, Goecke T. et al. Clinical risk factors for deep venous thrombosis in pregnancy and the puerperium. J Perinat Med 2002; 30: 367-70.
• 119 van Beek EJ, Brouwers EM, Song B. et al. Lung scintigraphy and helical computed tomography for the diagnosis of pulmonary embolism: a meta-analysis. Clin Appl Thromb Hemost 2001; 7: 87-92.
• 120 van den Belt AG, Prins MH, Lensing AW. et al. Fixed dose subcutaneous low molecular weight heparins versus adjusted dose unfractionated heparin for venous thromboembolism. Cochrane Database Syst Rev 2000: CD001100.
• 121 van der Heijden JF, Hutten BA, Büller HR. et al. Vitamin K antagonists or low-molecular-weight heparin for the long term treatment of symptomatic venous thromboembolism. Cochrane Database Syst Rev 2000; 4: CD002001-2002.
• 122 van Dongen CJ, Vink R, Hutten BA. et al. The incidence of recurrent venous thromboembolism after treatment with vitamin K antagonists in relation to time since first event: a meta-analysis. Arch Intern Med 2003; 163: 1285-93.
• 123 Vieillard-Baron A, Qanadli SD, Antakly Y. et al. Transesophageal echocardiography for the diagnosis of pulmonary embolism with acute cor pulmonale: a comparison with radiological procedures. Intensive Care Med 1998; 24: 429-33.
• 124 Wacker P, Wacker R, Kreft H-U. et al. Akute Lungenembolie: Die meisten Patienten weisen für die Diagnosestellung charakteristische Symptome auf. Ein Algorithmus für die Krankenhausnotaufnahme bzw. den Patient-ArztPrimärkontakt wird vorgeschlagen. Intensivmed 2004; 41: 283.
• 125 Wacker P, Wacker R, Kreft HU. et al. Akute Lungenembolie: Der echokardiographische Rechtsherz-Score ist nicht nur Prädiktor der Krankenhaussterblichkeit, sondern auch Prädiktor der 6-Monats-Sterblichkeit. Intensivmed 2004; 41: 270.
• 126 Warkentin TE. Heparin-induced thrombocytopenia: yet another treatment paradox?. Thromb Haemost 2001; 85: 947-9.
• 127 Wells PS, Anderson DR, Bormanis J. et al. Value of assessment of pretest probability of deep-vein thrombosis in clinical management. Lancet 1997; 350: 1795-8.
• 128 Wells PS, Anderson DR, Rodger M. et al. Evaluation of D-dimer in the diagnosis of suspected deep-vein thrombosis. N Engl J Med 2003; 349: 1227-35.
• 129 Wells PS, Forster AJ. Thrombolysis in deep vein thrombosis: is there still an indication?. Thromb Haemost 2001; 86: 499-508.
• 130 Wells PS, Ginsberg JS, Anderson DR. et al. Use of a clinical model for safe management of patients with suspected pulmonary embolism. Ann Intern Med 1998; 129: 997-1005.
• 131 Wells PS, Hirsh J, Anderson DR. et al. Accuracy of clinical assessment of deep-vein thrombosis. Lancet 1995; 345: 1326-30.
• 132 Wells PS, Rodger M. Diagnosis of pulmonary embolism: when is imaging needed?. Clin Chest Med 2003; 24: 13-28.
• 133 White RH. The epidemiology of venous thromboembolism. Circulation 2003; 107: 1-8.
• 134 Wicki J, Perneger TV, Junod AF. et al. Assessing clinical probability of pulmonary embolism in the emergency ward. Arch Intern Med 2001; 161: 92-7.
• 135 Wildberger JE, Mahnken AH, Schmitz-Rode T. et al. Individually adapted examination protocols for reduction of radiation exposure in chest CT. Invest Radiol 2001; 36: 604-11.