The decision whether to prescribe anticoagulation (AC) for deep vein thrombosis (DVT) or pulmonary embolism (PE), and for what duration, is a highly individualized one that must take into account several clinical variables as well as patient preferences. Recommendations for AC are tailored based on a patient’s bleeding risk profile, characteristics of DVT (proximal vs. distal) and the clinical context in which VTE has occurred (provoked by a major transient risk factor present within 3 months of VTE, provoked by minor transient risk factor within 2 months of diagnosis, provoked by a persistent risk factor, or unprovoked). The American College of Chest Physicians offers a comprehensive evidence-based guideline on how and when to treat VTE with anticoagulation. The new guideline statement also provides guidance based on phase of management
Low-risk PE, Outpatient Treatment is Adequate for Initiation Phase Over Hospitalization
Isolated subsegmental PE
Asymptomatic Acute PE
Acute PE with symptoms
Alternative Interventions in Acute PE
Acute PE without symptoms
Note: In patients with CAT and luminal GI malignancy, there is a higher risk of major bleeding with edoxaban and rivaroxaban compared to LMWH and apixaban | Consider apixaban or LMWH for these patients!
Patients with acute VTE in the setting of Antiphospholipid Syndrome (APS)
Superficial vein thrombosis
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