Isolated Distal Deep Vein Thrombosis in the Direct Oral Anticoagulant (DOAC) Era – Should Our Management Change?
Table 3.
Comparison of major guideline and key studies recommendations
| | Provoked | Unprovoked | Comments | | THANZ Guidelines 2019 [20] | 6 weeks of therapeutic anticoagulation | 3 months of therapeutic anticoagulation (also if persisting risk factors) | Serial ultrasound over 2 weeks is reasonable, especially if the patient has bleeding risk factors | | CHEST Guidelines[21] | Surgically provoked or non-surgical transient provoking factor – 3 months of anticoagulation | 3 months minimum of anticoagulation | | | NICE Guidelines[22] | No treatment recommendation specifically for IDDVT | If suspected DVT and negative proximal ultrasound scan and positive D-dimer test repeat proximal imaging in 6-8 days | | European Society of Cardiology[23] | 4-6 weeks full or low dose anticoagulation or venous ultrasound surveillance | 3 months of anticoagulation (also if high risk including previous VTE events, age >50 years, persistent hampered mobilisation, presence of predisposing diseases) | | | ASH Guidelines[24] | No treatment recommendation specifically for IDDVT | Diagnosis of VTE guidelines states that either whole leg or proximal leg ultrasound is appropriate (serial imaging if intermediate or high risk of DVT)[25] |
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