After deep vein thrombosis, which patients refer to vascular specialist for anticoagulant withdrawal? A Delphi study results between general practitioners and vascular specialists

Les situations consensuelles pour lesquelles le médecin généraliste pouvait arrêter de lui-même l'anticoagulation étaient les TVP distales isolées sans cancer associé et les TVP proximales avec facteur déclenchant majeur transitoire. Les situations pour lesquelles il était nécessaire d'avoir un avis spécialisé étaient les TVP idiopathiques, les TVP dans un contexte de grossesse, de post-partum ou de cancer et les TVP proximales dans un contexte de traitement hormonal.What was known
- After a DVT, the anticoagulant therapy duration must be adapted to each patient.
- The treatment reassessment in general practice is essential to avoid a long and unnecessary anticoagulant therapy.
- To achieve this reassessment, the recommendations do not clearly explain when to refer, or not, to a vascular specialist to stop treatment.What this study adds
- Situations in which the general practitioner can stop anticoagulation on his own are isolated distal DVT without an associated cancer, and proximal DVT caused by a major reversible risk factor, surgical or not.
- Situations justifying a vascular medical advice to stop processing, are idiopathic DVT, DVT provoked by pregnancy, postpartum, cancer (active or in remission), and proximal DVT in a context of hormonal therapy.