Table 3.20-4. Duration of VTE treatment depending on the clinical setting

3 months

– Proximal lower extremity DVT or pulmonary embolism caused by surgery or other transient risk factor

– Upper extremity DVT associated with a central venous catheter that has already been removed in patients with or without cancer

– Upper extremity DVT unrelated to a central venous catheter or to cancer

– First episode of VTE in the form of idiopathic proximal lower extremity DVT or idiopathic pulmonary embolism in patients at high risk of bleedinga

– First episode of isolated distal lower-extremity DVT

– Second episode of idiopathic VTE in patients at high risk of bleedinga

>3 monthsb

– Upper extremity DVT associated with a central venous catheter that has not yet been removed (anticoagulant treatment should be administered as long as the catheter remains in the central vein or for 3 months if the catheter is removed)

– Lower extremity DVT and active cancer (metastatic or treated within the prior 6 months)

– First episode of VTE in the form of idiopathic proximal lower extremity DVT in patients at low or moderate risk of bleedinga

– Second episode of idiopathic VTE in patients at low or moderate risk of bleedinga

a Risk factors for bleeding: see table 3.20-5.

b The need for continued treatment should be assessed periodically (eg, once a year).

DVT, deep vein thrombosis; VTE, venous thromboembolism.