Despite the availability of updated guidelines for the diagnosis and treatment of
venous thromboembolism (VTE), the management of this disorder in clinical practice is often not standardized, given the different degree of compliance with official recommendations by the various involved specialists. The aim of this consensus paper, as a result of a board of experts in
thromboembolism, is to define strategies to improve the quality of patients' care and the efficiency of healthcare resources utilization, by means of: (a) analysis of the guidelines for diagnosis and treatment of VTE; (b) analysis of diagnostic and therapeutic algorithms currently used in clinical practice by different specialists; (c) agreement on a common algorithm for diagnosis and treatment of VTE in different clinical settings; (d) definition of the possible role of the new oral
anticoagulant agents (
NOAC), such as
rivaroxaban, based on their potential benefits for both acute and chronic
therapy. The so-called "single drug approach" (as opposed to the traditional
heparin/VKA combination), which can be adopted with these drugs, makes anticoagulation more convenient for both patients and healthcare providers, without the need for a close monitoring of the hemocoagulative status, and with a concomitant reduction of length of hospitalization and treatment costs. Among NOACs, in this paper we focused on
rivaroxaban only because it was the unique available
NOAC in Italy for the treatment of VTE at the time the manuscript was written. Concerning
rivaroxaban, the results of two phase III, randomized and controlled trials confirm the non-inferiority of this drug compared to standard
therapy (
enoxaparin/
warfarin) for the treatment of patients with
pulmonary embolism (EINSTEIN PE Study) or
deep vein thrombosis (EINSTEIN DVT Study) in terms of both efficacy and safety, supporting its use as an effective therapeutic option for these disorders.