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Unprovoked proximal DVT duration of therapy — ABIM Board MCQ

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HardHematology/OncologyUnprovoked proximal DVT duration of therapyABIM Board

A 51-year-old woman has a first unprovoked proximal DVT. She has no cancer, no major bleeding risk, and normal renal function. After 3 months of apixaban, symptoms have resolved. D-dimer is mildly elevated after stopping anticoagulation for testing. Which of the following would you recommend?

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Correct answer: B — Continue extended anticoagulation after shared decision-making

For a first unprovoked proximal DVT with low bleeding risk, extended anticoagulation is commonly recommended because recurrence risk persists after stopping therapy. Patient preferences and bleeding risk guide duration and dose.

Reference: CHEST Antithrombotic Therapy for VTE Disease Guideline; ASH VTE Guideline