The Laboratory processing the samples has informed us that they will not be receiving any samples from 25th of December until 29th December due to Royal Mail courier not being operational on these days and hence samples NOT received by 24th December may expect delays in receiving their results. All orders between mentioned days will be dispatched on 4th of January for delivery on 5th of January. All arrivals between 31st December and 3rd January will also be expecting courier delays due to New Year’s day and Bank holidays. All orders between the mentioned days will be dispatched on 29th of December for delivery on 30th December. All rights reserved.All arrivals between 24th Dec to 28th December will be expecting courier delays due to Christmas and bank holidays. GRADE approach antithrombotic therapy evidence-based medicine venous thromboembolism.Ĭopyright © 2016 American College of Chest Physicians. Of 54 recommendations included in the 30 statements, 20 were strong and none was based on high-quality evidence, highlighting the need for further research. For recurrent VTE on a non-LMWH anticoagulant, we suggest LMWH (Grade 2C) for recurrent VTE on LMWH, we suggest increasing the LMWH dose (Grade 2C). We suggest thrombolytic therapy for pulmonary embolism with hypotension (Grade 2B), and systemic therapy over catheter-directed thrombolysis (Grade 2C). For subsegmental pulmonary embolism and no proximal DVT, we suggest clinical surveillance over anticoagulation with a low risk of recurrent VTE (Grade 2C), and anticoagulation over clinical surveillance with a high risk (Grade 2C). For DVT, we suggest not using compression stockings routinely to prevent PTS (Grade 2B). For VTE treated with anticoagulants, we recommend against an inferior vena cava filter (Grade 1B). We have not changed recommendations for who should stop anticoagulation at 3 months or receive extended therapy. For VTE and cancer, we suggest LMWH over VKA (Grade 2B), dabigatran (Grade 2C), rivaroxaban (Grade 2C), apixaban (Grade 2C), or edoxaban (Grade 2C). We generate strong (Grade 1) and weak (Grade 2) recommendations based on high- (Grade A), moderate- (Grade B), and low- (Grade C) quality evidence.įor VTE and no cancer, as long-term anticoagulant therapy, we suggest dabigatran (Grade 2B), rivaroxaban (Grade 2B), apixaban (Grade 2B), or edoxaban (Grade 2B) over vitamin K antagonist (VKA) therapy, and suggest VKA therapy over low-molecular-weight heparin (LMWH Grade 2C). We update recommendations on 12 topics that were in the 9th edition of these guidelines, and address 3 new topics.

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