Chest
Antithrombotic Therapy for Venous Thromboembolic Disease: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy
Section snippets
1.1 Initial treatment of acute DVT of the leg
Anticoagulation is the main therapy for acute DVT of the leg. The objectives of anticoagulant therapy in the initial treatment of this disease are to prevent thrombus extension and early and late recurrences of DVT and PE. The evidence for the need for anticoagulation in patients with DVT is based on studies performed > 40 years ago. The first and only trial1 evaluating heparin in patients with symptomatic PE that incorporated an untreated group was published in the 1960s. This trial1 showed a
1.1 Initial treatment of acute DVT of the leg
1.1.1. For patients with objectively confirmed DVT, we recommend short-term treatment with SC LMWH or IV UFH or SC UFH (all Grade 1A).
1.1.2. For patients with a high clinical suspicion of DVT, we recommend treatment with anticoagulants while awaiting the outcome of diagnostic tests (Grade 1C+).
1.1.3. In acute DVT, we recommend initial treatment with LMWH or UFH for at least 5 days (Grade 1C).
1.1.4. We recommend initiation of VKA together with LMWH or UFH on the first treatment day and
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