Feature Article

Venous thromboembolism: prevention, investigation and treatment

Justyn Huang, Craig Juergens



People at risk of developing venous thromboembolism (VTE) need to be identified so that they can commence prophylaxis, which may prevent significant morbidity and mortality. Investigation of the underlying cause of VTE is essential because this affects the duration and type of treatment.

Key Points

  • If there is clinical suspicion of a venous thromboembolism (VTE), the pretest probability of developing a VTE should be assessed with a scoring system (e.g. Wells score) as this may alter the investigation and treatment course.
  • In patients with current malignancy and VTE, it is recommended that low molecular weight heparin be used instead of warfarin.
  • New anticoagulants are on the horizon for the prevention and treatment of VTE but they are not currently included in the guidelines and do not have proven agents for reversing their effects.
  • Ultrasound can be used to guide the duration of anticoagulation in patients with deep vein thrombosis.
  • The underlying cause of VTE should be investigated as this affects the duration and type of treatment the patient receives.