Contemporary management of acute and chronic deep venous thrombosis

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This review aims to provide an update on the management of deep vein thrombosis (DVT).

Sources of data

A systematic search of PubMed, Google Scholar and Cochrane databases was carried out.

Areas of agreement

Direct oral anticoagulants (DOACs) are as effective and easier to use than vitamin K antagonists for the treatment of DVT. Catheter-directed thrombolysis can reduce post thrombotic syndrome in patients with iliofemoral DVT. Compression bandaging can help heal a venous ulcer.

Areas of controversy

Compression hosiery to prevent post thrombotic syndrome. Long-term evidence to show clinical benefit of using endovenous therapies to restore deep vein patency.

Growing points

Developing imaging methods to identify patients who would benefit from venous thrombolysis. The evolution of dedicated venous stents.

Areas timely for developing research

Understanding the mechanisms that lead to stent occlusion and investigation into the appropriate treatments that could prevent in-stent thrombosis is required.

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