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The optimal duration of oral anticoagulation therapy after an initial symptomatic deep venous thrombosis remains unknown. Siragusa et al assessed patients by ultrasonography for the presence of residual vein thrombosis (RVT) after three months of anticoagulation for a DVT. Those with RVT were randomized to 9 additional months of anticoagulation versus discontinuation. Among the 70% with RVT, prolonged anticoagulation showed only a non-significant trend for reducing recurrent DVT. For the 30% without RVT, all of whom stopped anticoagulation after three months, only one of 78 patients (1.3%) developed a recurrent DVT. For select patients, the lack of RVT after initial anticoagulation identifies patients in whom anticoagulation may be safely discontinued. The optimal duration of anticoagulation for higher risk patients, including those with RVT, remains undefined.

Lack of Residual Vein Thrombosis Predicts for Low Risk of Recurrent DVT