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Venous Thromboembolism — MRCP Part 1 MCQ

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HardHematologyVenous ThromboembolismMRCP Part 1

A patient has completed three months of anticoagulation for a proximal DVT provoked by major surgery. Recovery is complete, the provoking factor has resolved and the course has been uncomplicated. What should now be considered?

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Correct answer: A — Stop anticoagulation after a documented risk–benefit review

The best answer is “Stop anticoagulation after a documented risk–benefit review”. NICE reviews anticoagulation at three months and considers stopping after an uncomplicated provoked DVT or PE when the transient factor has gone. Residual thrombus on ultrasound is not required to determine duration. Indefinite therapy exposes this lower-recurrence-risk patient to avoidable bleeding, while antiplatelets do not complete VTE treatment.

Reference: NICE NG158, Venous thromboembolic diseases: https://www.nice.org.uk/guidance/ng158/chapter/Recommendations