DOAC Treatment Duration

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Type of Thrombotic Event Duration of Anticoagulant Therapy
Superficial vein thrombophlebitis No anticoagulation suggested

Treat with supportive care (analgesia, warm compresses, and NSAIDs) and image if symptoms progress
Superficial vein thrombosis ASH: Anticoagulation for 6 weeks if ≥5 cm in length, close to the deep venous system, or other thrombophilic risk factors exist

CHEST: Fondaparinux for 45 days if increased risk for clot progression (extensive SVT; involvement above the knee; severe symptoms; involvement of the greater saphenous vein; history of DVT, PE, or SVT; active cancer; recent surgery)

If not anticoagulated, follow up in 1 week and image if symptoms are persistent or worsening
Distal leg DVT
No severe symptoms or risk factors for extension (positive D-dimer, close to proximal veins, multiple veins involved, >5 cm clot, active cancer, previous VTE, hospitalization, COVID-19, unprovoked) Serial imaging over 2 weeks
Severe symptoms or risk factors for extension 3-6 months
Proximal leg DVT or PE
Provoked (by surgery, trauma, immobility) ASH: 3-6 months

CHEST: 3 months
Unprovoked Extendedb
Recurrent Duration of therapy depends on whether VTE events were provoked or unprovoked
Upper extremity DVT, proximal 3 months or as long as a central venous catheter remains in place
Cancer-associated DVT or PE As long as the cancer is active or being treated

ASCO/ASH: LMWH or DOACs are the preferred anticoagulantsc

CHEST: Apixaban, edoxaban, or rivaroxaban
Chronic thromboembolic pulmonary hypertension Extended