4. Patient with suspect symptomatic
Acute lower extremity DVT
Venous duplex scan negative Low clinical probability observe
High clinical probability
positive negative
Repeat scan /
Venography
Evaluate coagulogram /thrombophilia/ malignancy
Anticoagulant therapy
contraindication
yes IVC filter
No
pregnancy LMWH
OPD LMWH
hospitalisation UFH
+ warfarin
Compression treatment
5. Thrombophilia screening
Factor V leiden, Prot C/S deficiency
Antithrombin III deficiency
• Idiopathic DVT < 50 years
• Family history of DVT
• Thrombosis in an unusual site
• Recurrent DVT
6. Recommendation for
duration of warfarin
• 3-6 months first DVT with reversible risk
factors
• At least 6 months for first idiopathic DVT
• 12 months to lifelong for recurrent DVT or
first DVT with irreversible risk factors
malignancy or thrombophilic state