American evidence-based clinical guidelines were published in 2016 for the treatment of<unk> E. In the UK, guidelines by the National Institute for Health and Care Excellence (NICE) were published in 2012, updated in 2020. These guidelines do not cover rare forms of thrombosis, for which an individualized approach is often needed. Central and branch retinal vein occlusion does not benefit from anticoagulation in the way that other<unk>  do. Anticoagulation If diagnostic testing cannot be performed swiftly, many are commenced on empirical treatment. Traditionally this was heparin, but several of the DOACs are licensed for treatment without initial heparin use. If heparin is used for initial treatment of<unk> E, fixed doses with low-molecular-weight heparin (LMWH) may be more effective than adjusted doses of unfractionated heparin (UFH) in reducing blood clots. No differences in mortality, prevention of major bleeding, or preventing<unk> Es from recurring were observed between LMWH and UFH. No differences have been detected in the route of administration of UFH (subcutaneous or intravenous). LMWH is usually administered by a subcutaneous injection, and a person's blood clotting factors do not have to be monitored as closely as with UFH. Once the diagnosis is confirmed, a decision needs to be made about the nature of the ongoing treatment and its duration. USA recommendations for those without cancer include anticoagulation (medication that prevents further blood clots from forming) with the DOACs dabigatran, rivaroxaban, apixaban, or edoxaban rather than warfarin or low molecular weight heparin (LMWH). For those with cancer, LMWH is recommended, although DOACs appear safe in the majority of situations. For long-term treatment in people with cancer, LMWH is probably more effective at reducing<unk> Es when compared to vitamin K antagonists. People with cancer have a higher risk of experiencing reoccurring<unk> E episodes ("recurrent<unk> E"), even while taking preventative anticoagulation medication. These people should be given therapeutic doses of LMWH medication, either by switching from another anticoagulant or by taking a higher dose of LMWH. In pregnancy, warfarin and DOACs are not considered suitable and LMWH is recommended. For those with a small pulmonary embolism and few risk factors, no anticoagulation is needed. Anticoagulation is, however, recommended in those who do have risk factors. Thrombolysis Thrombolysis is the administration of medication (a recombinant enzyme) that activates plasmin, the body's main enzyme that breaks down blood clots. This carries a risk of bleeding and is therefore reserved for those who have a form of thrombosis that may cause major complications. In pulmonary embolism, this applies in situations where heart function is compromised due to lack of blood flow through the lungs ("massive" or "high risk" pulmonary embolism), leading to low blood pressure. Deep vein thrombosis may require thrombolysis if there is a significant risk of post-thrombotic syndrome. Thrombolysis may be administered by intravenous catheter directly into the clot ("catheter-directed thrombolysis"); this requires a lower dose of the medication and may carry a lower bleeding risk but evidence for its benefit is limited. Inferior vena cava filters Inferior vena cava filters (IVCFs) are not recommended in those who are on anticoagulants. IVCFs may be used in clinical situations where a person has a high risk of experiencing a pulmonary embolism, but cannot be on anticoagulants due to a high risk of bleeding, or they have active bleeding. Retrievable IVCFs are recommended if IVCFs must be used, and a plan should be created to remove the filter when it is no longer needed. Superficial<unk>  While topical treatments for superficial<unk>  are widely used, the evidence is strongest for the heparin-like drug fondaparinux (a factor Xa inhibitor), which reduces extension and recurrence of superficial<unk>  as well as progression to symptomatic embolism.
Venous thrombosis
Migraine
Deep vein thrombosis
Venous ulcer
Thrombophlebitis
Phlebitis
Thrombosis
Lymphangitis