Prior to the development of anticoagulant therapy, untreated venous thromboembolism (VTE) was often fatal with up to 30% of cases dying . Anticoagulant therapy effectively treats the symptoms of VTE and decreases recurrent VTE and death, but anticoagulation increases the risk of major haemorrhage, and when a patient suffers a major haemorrhage, it can be fatal in up to 25% of cases [34, 35]. Understanding the balance of risk and benefit of treatment options helps to inform management decisions . The risk and benefit balance is best evaluated from two perspectives:
The acute and long-term phases are treated the same for provoked and unprovoked VTE. Aetiology becomes relevant for the extended phase; malignancy-associated VTE has different recommendations in all phases of treatment .