Home versus in-patient treatment for deep vein thrombosis

Deep vein thrombosis (DVT) is a condition that develops when blood flow through a deep vein is obstructed by a blood clot. DVT occurs after surgery, trauma and lengthy periods of immobilisation, as well as in conjunction with malignancy; it may also occur spontaneously (Othieno et al, 2018). During the acute phase, patients report lower-leg symptoms and, in a minority of cases, clot dislodgement may occur, leading to potentially fatal pulmonary embolism (PE). DVT and PE are collectively known by the term ‘venous thromboembolism’ (VTE). The gold-standard practice for diagnosis of DVT includes ascending venography and duplex ultrasound scanning, and clinical management usually involves the administration of anticoagulants. These agents are used to prevent the spread of the clot proximally and to allow it to become adherent or undergo fibrinolysis, thus decreasing the risk of PE. The anticoagulant treatments used include unfractionated heparin (UFH), low molecular heparin (LMWH), vitamin K antagonists, such as warfarin, and direct oral anticoagulants (National Institute for Health and Care Excellence, 2012; van Es et al, 2014; Robertson et al, 2015).