The Curbsiders Internal Medicine Podcast UNLOCKED PATREON #60 Anticoagulation DVT/PE
52 snips
Dec 29, 2025 In this enlightening discussion, experts explore the nuances of anticoagulation for venous thromboembolism. They dive into the pros and cons of DOACs, highlighting the preference for apixaban due to safety considerations. The hosts share insights on dosing strategies, duration of therapy, and when to conduct hypercoagulable testing. They tackle management of distal DVT and address special cases like bariatric patients. Plus, discover their exciting recommendations, including gripping novels and a visually stunning video game!
AI Snips
Chapters
Transcript
Episode notes
Default To Apixaban For Many VTE Cases
- Favor apixaban over rivaroxaban for most VTE patients, especially with renal impairment or higher bleeding risk.
- Use rivaroxaban when renal function is intact and insurance or patient factors make it preferable.
Why Starter DOAC Doses Exist
- Initial higher-dose 'starter' DOAC regimens exist because trials used them and to get patients therapeutic quickly.
- The highest recurrence risk is front-loaded early after clot, so early intensified dosing makes sense.
Decide Duration By Provocation
- Use the provoking vs unprovoked distinction to pick anticoagulation duration: 3 months for clearly provoked events.
- Offer lifelong anticoagulation for unprovoked VTE unless specific reasons to stop exist.