Venous thromboembolism — treating with the appropriate anticoagulant and duration

Published on 28 May 2018
Last Updated on 16 May 2024

This ACE Clinical Guidance (ACG) provides evidence-based recommendations on selecting an appropriate anticoagulant and treatment duration for different patient groups with venous thromboembolism (VTE), such as patients from the general population (including those with severe renal impairment or liver disease) and those with active cancer. Guidance on when to extend therapy is also provided.

First published in 2018, the ACG on VTE treatment has been updated to incorporate the latest evidence where relevant.

Download the ACG

VTE - Treating with the appropriate anticoagulant and duration (May 2024) [PDF]

A supplementary guide on switching between anticoagulants is included.

ACG recommendations

1. Start anticoagulation as soon as possible for patients with confirmed proximal DVT or PE, unless contraindicated.

2. For patients from the general population, use a DOAC for at least 3 months as the preferred anticoagulant for VTE treatment; consider warfarin as an alternative if DOACs are not suitable.

3. For patients with cancer needing VTE treatment, use apixaban, edoxaban, rivaroxaban, or LMWH for the initial and treatment phases for at least 6 months; LMWH is preferred if the patient has gastrointestinal cancer.

ACG references

VTE - Treating with the appropriate anticoagulant and duration – references (May 2024) [PDF]