EVF-AVF Joint Session: DVT Guidelines and Ulcer Care

2021 Anticoagulation Guidelines for DVT

Stavros Konstantinides presented guidelines recommending direct oral anticoagulants over vitamin K antagonists across all DVT phases, three months of therapy for provoked proximal DVT, and extended anticoagulation for unprovoked DVT after reassessing bleeding risk, often at a reduced dose.

European Guidelines on Early Thrombus Removal

Manj Gohel presented new European guidelines finding early thrombus removal reduces moderate to severe post-thrombotic syndrome only in iliofemoral DVT with low bleeding risk, showing no benefit and more major bleeding for isolated femoropopliteal disease.

Duplex Criteria for Iliac Venous Obstruction

Elna Masuda reviewed duplex parameters for detecting iliac venous obstruction, finding no single measure has adequate sensitivity, though monophasic flow, persistent cephalad flow with Valsalva, and elevated velocity ratios combine with provocative maneuvers to improve detection.

Updating Venous Leg Ulcer Treatment Guidelines

Bill Marston argued existing venous leg ulcer guidelines are outdated, since the EVerEST trial showed early superficial vein ablation speeds healing, and called for new multispecialty guidelines and studies validating perforator ablation and deep venous outflow correction.