Treatment of isolated distal deep vein thrombosis: an international survey of healthcare professionals

Isolated distal deep venous thrombosis (iDDVT) is an infra-popliteal DVT without pulmonary embolism (PE). It is a common condition, but its management remains debated. We conducted a survey distributed by email to the members of the French Society of Vascular Medicine, Thrombosis Canada, the Swiss Society of Angiology and INVENT-VTE research networks; Our objectives were to determine how healthcare professionals specialized in thrombosis manage iDDVT and to obtain experts input on the design of a future clinical trial. Participants were asked how they diagnosed and managed iDDVT and what should be the treatment arms of a future clinical trial on iDDVT management. 472 thrombosis specialists answered the questionnaire, mainly from France (n = 337), Canada (n = 61) and Switzerland (n = 28). Overall, 87.9% (n = 405) of respondents stated that their center always performed whole leg ultrasound in case of suspected DVT and that they managed patients with iDDVT usually at least once a week in 50.3% (n = 229) of cases. In 91.0% (n = 415) of cases respondents treated patients with iDDVT with anticoagulation more than 75% of time, with therapeutic doses and for a duration of 3 months in 90.2% (n = 406) and 74.7% (n = 334) of cases respectively. Most respondent managed muscular and deep-calf vein DVT similarly. More than 60% of respondents favored future trials comparing prophylactic versus therapeutic anticoagulation. Our real-world, international, practice survey of healthcare professionals shows that almost all respondents always conduct whole leg ultrasonography in case of suspected DVT and that they treat iDDVT with therapeutic anticoagulation usually for 3 months.