Management of IlioFemoral Deep Vein Thrombosis

Management of IlioFemoral Deep Vein Thrombosis

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Management of Massive & Submassive Pulmonary Embolism, Iliofemoral Deep Vein Thrombosis, and Chronic Thromboembolic Pulmonary Hypertension

Circulation. 2011;123:1788-1830

Initial Anticoagulant Therapy

• UFH: initial bolus IV 80 U/kg followed by continuous infusion 18 U/kg‧h

• LMWH: Enoxaparin 1 mg/kg SC BID or 1.5 mg/kg QD

• Fondaparinux SC QD

5 mg for patients weighing <50 kg
7.5 mg for patients weighing 50 to 100 kg
10 mg for patients weighing >100 kg

• Adult patients with IFDVT who receive oral warfarin as first-line long-term anticoagulation therapy should have warfarin overlapped with initial anticoagulation therapy for a minimum of 5 days and until the INR is >2.0 for at least 24 hours, and then targeted to an INR of 2.0 to 3.0

Recommendations for Endovascular Thrombolysis and Surgical Venous Thrombectomy

Catheter-directed thrombolysis (CDT) or pharmacomechanical CDT should be given to patients with IFDVT associated with limb-threatening circulatory compromise (ie, phlegmasia cerulea dolens)