Fellows Course: DVT and PE Anticoagulation Guidelines
Iliac DVT: Anticoagulation Versus Catheter-Directed Therapy
Chest guidelines recommend anticoagulation alone for iliac vein DVT unless the limb is threatened, while UK Nice guidelines allow catheter directed therapy more liberally, with panelists stressing that patient age and bleeding risk should guide who receives thrombolysis.
Cancer-Associated VTE: DOACs and Treatment Duration
Updated guidelines now favor direct oral anticoagulants over low molecular weight heparin for cancer associated thrombosis, except in luminal gastrointestinal malignancies where apixaban or low molecular weight heparin is preferred given bleeding profile data.
Stopping Anticoagulation After a Transient Risk Resolves
Guidelines recommend stopping anticoagulation after three months once a transient risk factor like surgery or immobility resolves, even in active cancer patients, a recommendation panelists found surprising and worth reassessing with imaging or D-dimer before stopping.
PE Risk Stratification and Treatment Escalation
Intermediate risk PE patients with elevated troponin and RV enlargement should receive catheter directed therapy, while hypotensive patients are treated with systemic thrombolysis, with catheter therapy reserved for those where lysis fails or carries high bleed risk.
