Deep vein thrombosis (DVT) – Treatment

Treatment approach for lower extremity vein thrombosis. For superficial vein thrombosis (SVT), anticoagulation is generally recommended for isolated SVT ≥ 5 cm and/or located within 3 cm of the sapheno-femoral junction. While clinical practice guidelines recommend using fondaparinux in this situation, DOACs are also reasonable. Proximal deep vein thrombosis (DVT) is treated with anticoagulation, preferably DOAC (except in the case of a patient with antiphospholipid syndrome), the duration of which depends on whether the DVT was provoked or not. Distal DVT (isolated to the deep veins below the knee including the paired peroneal veins, posterior tibial vein and anterior tibial vein) may be treated with anticoagulation or monitored off treatment for proximal extension using Doppler ultrasound. See next slide for graphic of leg veins.