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Deep vein thrombosis - Management
How should a person with confirmed deep vein thrombosis be followed up?

  • All people who have been diagnosed with deep vein thrombosis (DVT) require maintenance treatment with anticoagulant drugs (usually warfarin) following acute treatment. For further information on the use of anticoagulant drugs, see the CKS topic on Anticoagulation - oral.
    • Most people requiring anticoagulants are likely to attend a dedicated clinic in a hospital, or an outreach clinic in primary care. Specialists will make clinical decisions such as the duration of treatment and whether drugs other than warfarin are required.
    • Usually the strategy is to aim for an international normalized ratio (INR) target of 2.5, keeping within the range of 2.0–3.0.
    • The duration of treatment is usually 3–6 months, but may be shorter or longer, depending on the risk of recurrence.
  • Most people who are diagnosed with DVT require below-knee compression stockings:
    • Class 3 (25 mmHg to 35 mmHg) are recommended for a duration of 2 years (unless there are contraindications). However, class 2 stockings (18 mmHg to 24 mmHg) may be used if class 3 stockings are poorly tolerated.
    • People with established post-phlebitic symptoms will probably benefit from ongoing use of compression stockings (that is, for more than 2 years).
    • The prescription for compression stockings should be renewed every 3–6 months or so if the stockings are used every day. For more information about using compression stockings, and prescriptions, see the CKS topic on Compression stockings.
  • Advise the person:
    • To engage in regular walking exercise after they are discharged from hospital (unless a specialist advises against this).
    • That the affected leg should be elevated when sitting.
    • That extended travel, or travel by aeroplane, should be delayed until at least 2 weeks after starting anticoagulant treatment. Travel within 2 weeks of a DVT is not recommended without seeking advice from a specialist. For more information, see the CKS topic on DVT prevention for travellers.

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