Antithrombotic Therapy for VTE Disease: CHEST Guideline and Expert Panel Report.

We update recommendations on 12 topics that were in the 9th edition of these guidelines, and address 3 new topics. We generate strong (Grade 1) and weak (Grade 2) recommendations based on high- (Grade A), moderate- (Grade B), and low- (Grade C) quality evidence. For VTE and no cancer, as long-term anticoagulant therapy, we suggest dabigatran (Grade 2B), rivaroxaban (Grade 2B), apixaban (Grade 2B), or edoxaban (Grade 2B) over vitamin K antagonist (VKA) therapy, and suggest VKA therapy over low-molecular-weight heparin (LMWH; Grade 2C). For VTE and cancer, we suggest LMWH over VKA (Grade 2B), dabigatran (Grade 2C), rivaroxaban (Grade 2C), apixaban (Grade 2C), or edoxaban (Grade 2C). We have not changed recommendations for who should stop anticoagulation at 3 months or receive extended therapy. For VTE treated with anticoagulants, we recommend against an inferior vena cava filter (Grade 1B). For DVT, we suggest not using compression stockings routinely to prevent PTS (Grade 2B). For subsegmental pulmonary embolism and no proximal DVT, we suggest clinical surveillance over anticoagulation with a low risk of recurrent VTE (Grade 2C), and anticoagulation over clinical surveillance with a high risk (Grade 2C). We suggest thrombolytic therapy for pulmonary embolism with hypotension (Grade 2B), and systemic therapy over catheter-directed thrombolysis (Grade 2C). For recurrent VTE on a non-LMWH anticoagulant, we suggest LMWH (Grade 2C); for recurrent VTE on LMWH, we suggest increasing the LMWH dose (Grade 2C). Of 54 recommendations included in the 30 statements, 20 were strong and none was based on high-quality evidence, highlighting the need for further research.

Kearon C ，Akl EA ，Ornelas J ，Blaivas A ，Jimenez D ，Bounameaux H ，Huisman M ，King CS ，Morris TA ，Sood N ，Stevens SM ，Vintch JRE ，Wells P ，Woller SC ，Moores L ... -  《-》

Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.

Kearon C ，Akl EA ，Comerota AJ ，Prandoni P ，Bounameaux H ，Goldhaber SZ ，Nelson ME ，Wells PS ，Gould MK ，Dentali F ，Crowther M ，Kahn SR ... -  《-》

Venous thromboembolism, thrombophilia, antithrombotic therapy, and pregnancy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition).

Bates SM ，Greer IA ，Pabinger I ，Sofaer S ，Hirsh J ... -  《CHEST》

Antithrombotic therapy for venous thromboembolic disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition).

Kearon C ，Kahn SR ，Agnelli G ，Goldhaber S ，Raskob GE ，Comerota AJ ... -  《CHEST》

Prevention of VTE in nonorthopedic surgical patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.

Gould MK ，Garcia DA ，Wren SM ，Karanicolas PJ ，Arcelus JI ，Heit JA ，Samama CM ... -  《-》