Prevention and treatment of bleeding complications in patients receiving vitamin K antagonists, Part 2: Treatment

Major bleeding complicates oral vitamin K antagonist therapy in 1-3% of patients annually. However, there is a paucity of published research, which provides evidence to guide management of bleeding. To assist physicians dealing with these potentially serious events in their daily clinical practice, we assembled a panel of international experts and posed them a series of focused clinical questions. The experts were asked to perform a systematic literature review and summarize the results of that review within the context of their clinical question. In most cases, data were lacking and the experts were asked to supplement their answer with clinical expertise. To minimize bias, the reviews were vetted by members of the Italian Society for Studies on Hemostasis and Thrombosis, the Federation of Centers for the Diagnosis of Thrombosis and Surveillance of Antithrombotic Therapies, and the Anticoagulation Forum. Our goal in this project is to provide "best evidence" to assist clinicians faced with actively bleeding patients.