management of iliofemoral venous thrombosis in injecting drug users is problematic because of poor venous access, non-compliance with prescribed treatment, ongoing intravenous drug use and co-existent sepsis
because of the great variation in response to warfarin between and within patients it is not appropriate to use oral anticoagulants when monitoring of the patient is not possible or probable for whatever reason
national guidance suggests that treatment with low molecular weight heparin is an alternative to oral anticoagulation in patients with venous thromboembolism secondary to intravenous drug use (1)
Reference:
Baglin TP et al.D. the British Committee for Standards in Haematology (2006) Guidelines on oral anticoagulation (warfarin): third edition - 2005 update British Journal of Haematology 2006; 132 (3): 277–285.
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