Overview of extended therapy for VTE

Extended therapy for venous thromboembolism (VTE) (ie deep vein thrombosis [DVT] or pulmonary embolism [PE]) refers to a duration that extends beyond the initial period of anticoagulant therapy.

Extended therapy is usually considered for patients with recurrent unprovoked proximal DVT or PE, and those at increased risk of VTE recurrence. For common factors predicting the recurrence of VTE, see Common factors predicting recurrence of venous thromboembolism. To help stratify a patient’s risk of VTE recurrence, consider using either the DASH prediction score for recurrent VTE or the HERDOO2 rule for discontinuing anticoagulation in unprovoked VTE.

The decision to use extended therapy depends on the balance of the risk of bleeding against the risk of VTE recurrence. The patient’s preference must also be considered.

Extended therapy is given as low-intensity anticoagulant therapy, full-dose therapeutic anticoagulation or low-dose aspirin.