Venous thromboembolism: DVT, PE and complications
Pre-test probability and D-dimer strategies, PE severity (ESC 2019 and the 2026 AHA/ACC A to E categories), DOAC choice and its exceptions, who gets thrombolysis, how long to anticoagulate, and the late complications of CTEPH and post-thrombotic syndrome.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- DVT and PE are one disease. About half of proximal DVTs have silent PE and most PEs come from leg veins.
- Diagnosis runs on pre-test probability first, then D-dimer (only if probability is not high), then imaging.
- Risk-stratify PE before choosing the setting and treatment. Most patients are low risk and can be treated as outpatients.
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Sources
- New guidelines from the Thrombosis and Haemostasis Society of Australia and New Zealand for the diagnosis and management of venous thromboembolismAU/NZTran HA et al., Med J Aust 2019;210:227-35, 2019
- Therapeutic Guidelines, Cardiovascular (venous thromboembolism)AU/NZTherapeutic Guidelines Ltd
- 2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN Guideline for the Evaluation and Management of Acute Pulmonary Embolism in AdultsAmerican Heart Association and American College of Cardiology, Circulation 2026;153:e977-e1051, 2026
- 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolismKonstantinides SV et al., Eur Heart J 2020;41:543-603, 2019
- American Society of Hematology 2020 guidelines for management of venous thromboembolism: treatment of deep vein thrombosis and pulmonary embolismOrtel TL et al., Blood Adv 2020;4:4693-738, 2020
- Antithrombotic therapy for VTE disease: second update of the CHEST guideline and expert panel reportStevens SM et al., Chest 2021;160:e545-608, 2021
- Fibrinolysis for patients with intermediate-risk pulmonary embolism (PEITHO)Meyer G et al., N Engl J Med 2014;370:1402-11, 2014
- Catheter-directed thrombolysis in intermediate-high-risk pulmonary embolism (PRAGUE-26)Kroupa J et al., N Engl J Med 2026, 2026
- Apixaban for extended treatment of cancer-associated venous thromboembolism (API-CAT)Mahé I et al., N Engl J Med 2025;392:1363-73, 2025
- Simplified diagnostic management of suspected pulmonary embolism (the YEARS study)van der Hulle T et al., Lancet 2017;390:289-97, 2017
- Compression stockings to prevent post-thrombotic syndrome (SOX)Kahn SR et al., Lancet 2014;383:880-8, 2014
- Last updated
- 14 November 2026
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