What are the current NICE guidelines for the assessment and management of patients with suspected DVT?

For people who present with signs or symptoms of DVT, such as a swollen or painful leg, assess their medical history and perform a physical examination to exclude other causes ¹.

If DVT is suspected, use the 2‑level DVT Wells score to estimate clinical probability ¹.

For a Wells score of 2 points or more (DVT likely), offer a proximal leg vein ultrasound scan with results available within 4 hours if possible, and a D‑dimer test if the scan is negative ¹.

If a proximal leg vein ultrasound scan cannot be obtained within 4 hours, offer a D‑dimer test, interim therapeutic anticoagulation, and a scan within 24 hours ¹.

If the ultrasound scan is positive, offer or continue anticoagulation treatment or mechanical intervention if anticoagulation is contraindicated ¹.

If the Wells score is 1 point or less (DVT unlikely), offer a D‑dimer test with results available within 4 hours, or interim anticoagulation while awaiting results if testing is delayed ¹.

If the D‑dimer test is negative, stop anticoagulation and discuss signs and symptoms of DVT with the patient ¹.

If the D‑dimer test is positive, proceed with a proximal leg vein ultrasound scan, and follow subsequent actions based on the scan result ¹.