Prophylaxis of venous thromboembolism is a major health problem in everyday clinical practice. The therapeutic anticoagulants available to clinicians for prophylaxis of VTE is mainly composed by parenteral anticoagulants and oral vitamin K antagonists, warfarin. Oral vitamin K antagonists have several limitations, including a narrow therapeutic window and a metabolism that is affected by multiple drug and herbal interactions, vitamin K intake and genetic polymorphisms. The present review explore causes of poor prevention of thromboembolism and evaluated some new anticoagulants. The main target of new anticoagulants is to replace oral vitamin K antagonists for long-term anticoagulation. Moreover the role of genetics and the novel concept of cell therapy is evaluated. The hypothesis is that the patho-physiology of thrombosis may involve a "physiologic" cell that provides the same repair molecules that are used for treatment of thrombotic disorders
