Bridging therapy in patients with a history of DVT

What is your opinion on using bridging therapy in patients with a history of deep vein thrombosis (DVT)?

James Douketis: After DVT, if patients need to interrupt their anticoagulant because they are bleeding or they need a surgery, if it is within the first 3 weeks, you probably want to put them on an inferior vena cava filter because you want to protect them. If they have a bleed or if they have surgery, they have to be off anticoagulants for a few days.

If the DVT was a little bit further away, let’s say 1 to 3 months – yes, you would interrupt the anticoagulant and probably bridge most of those patients with therapeutic-dose low-molecular-weight heparin.