Treatment Acute VTE
ÎIn patients with acute VTE who are treated with anticoagulant therapy, the ACCP recommends long-term therapy over stopping anticoagulant therapy after about 1 week of initial therapy (1-B).
• In patients with a high clinical suspicion of acute venous thromboembolism (VTE), the ACCP suggests treatment with parenteral anticoagulants compared with no treatment while awaiting the results of diagnostic tests (2-C).
• In patients with an intermediate clinical suspicion of acute VTE, the ACCP suggests treatment with parenteral anticoagulants compared with no treatment if the results of diagnostic tests are expected to be delayed for more than 4 hours (2-C).
• In patients with a low clinical suspicion of acute VTE, the ACCP suggests NOT treating with parenteral anticoagulants while awaiting the results of diagnostic tests, provided test results are expected within 24 hours (2-C).
ÎIn patients with a first VTE that is an unprovoked proximal DVT of the leg and who have a low or moderate bleeding risk, the ACCP suggests extended anticoagulant therapy over 3 months of therapy (2-B).
ÎIn patients with a first VTE that is an unprovoked proximal DVT of the leg and who have a high bleeding risk, the ACCP recommends 3 months of anticoagulant therapy over extended therapy (1-B).
ÎIn patients with a first VTE that is an unprovoked isolated distal DVT of the leg, the ACCP suggests 3 months of anticoagulant therapy over extended therapy in those with a low or moderate bleeding risk (2-B) and recommends 3 months of anticoagulant treatment in those with a high bleeding risk (1-B).a
ÎIn patients with a second unprovoked VTE, the ACCP recommends extended anticoagulant therapy over 3 months of therapy in those who have a low bleeding risk (1-B), and the ACCP suggests extended anticoagulant therapy in those with a moderate bleeding risk (2-B).
ÎIn patients with a second unprovoked VTE who have a high bleeding risk, the ACCP suggests 3 months of anticoagulant therapy over extended therapy (2-B).
a
Duration of treatment of patients with isolated distal DVT refers to patients in whom a decision has been made to treat with anticoagulant therapy. However, it is anticipated that not all patients who are diagnosed with isolated distal DVT will be prescribed anticoagulants.
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