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Suspected DVT

Pretest probability

High/Moderate

Low

Start anticoagulation unless contraindicated, while awaiting results

Wait to start anticoagulation, if results will be available within 24 hours

DVT confirmed

Anticoagulants contraindicated

Anticoagulants not contraindicated

Treat with inferior vena cava (IVC) filter

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Stable DVT

Acute DVT

Initiate treatment with warfarin 10 mg, first 2 days or other VKA's Adjust dose based on INR

Home conditions stable? Good living conditions Strong support from friends/family Access to hospital, in case clinical condition deteriorates Hemodynamic status stable?

Treat at home

Hospitalize and treat

Choose one of the following parenteral anticoagulants: LMWH > Fondaparinaux > IV UFH > SC UFH LMWH: Enoxaparin 1 mg/kg every 12 hours Tinzaparin 175 IU/kg four times a day Dalteparin 100 IU/kg every 12 hours Fondaparinaux: 7.5 mg once daily IV UFH: Recommended doses Bolus 80 U/kg followed by 18 U/kg/hour or Bolus 5000 U followed by 1000 U/hour SC UFH: 333 U/kg Initate VKA, continue parenteral therapy till INR > 2.0 over 24 hours Total duration of therapy: First time DVT: Treat for 3 months Recurrent DVT: Treat for 6 months Recurrent DVT with high/moderate risk of bleeding: Treat for 3 months