Contemporary management of acute and chronic deep venous thrombosis

Introduction: This review aims to provide an update on the management of deep vein thrombosis (DVT). Sources of data: A systematic search of PubMed, Google Scholar and Cochrane databases was carried out. Areas of agreement: Direct oral anticoagulants (DOACs) are as effective and easier to use than vitamin K antagonists for the treatment of DVT. Catheter-directed thrombolysis can reduce post thrombotic syndrome in patients with iliofemoral DVT. Compression bandaging can help heal a venous ulcer. Areas of controversy: Compression hosiery to prevent post thrombotic syndrome. Long-term evidence to show clinical benefit of using endovenous therapies to restore deep vein patency. Growing points: Developing imaging methods to identify patients who would benefit from venous thrombolysis. The evolution of dedicated venous stents. Areas timely for developing research: Understanding the mechanisms that lead to stent occlusion and investigation into the appropriate treatments that could prevent in-stent thrombosis is required.