Guidance
This guideline covers the diagnosis and management of venous thromboembolic diseases in adults (aged 18 and over), and the role of thrombophilia testing. It aims to clarify which diagnostic tests should be used, reduce variation in pharmacological therapies, and provide guidance on when thrombophilia testing is useful.
This guideline was previously called venous thromboembolic diseases: the management of venous thromboembolic diseases and the role of thrombophilia testing.
In November 2015, new recommendations were added on elastic graduated compression stockings, and on pharmacological therapy for patients with a pulmonary embolism who are haemodynamically stable.
Recommendations
This updated guideline includes recommendations on:
Who is it for?
- Commissioners and providers of venous thromboembolism services
- Healthcare professionals in primary, secondary and tertiary care
- Adults (18 and over) with suspected or confirmed deep vein thrombosis or pulmonary embolism, and their families and carers
- First-degree relatives of people with inherited thrombophilia or other venous thromboembolic diseases
Is this guideline up to date?
We reviewed the evidence in November 2016 and we are updating the recommendations in the following 3 areas of the guideline:
- Diagnostic investigations for pulmonary embolism (PE)
- Pharmacological interventions – anticoagulation treatment for deep vein thrombosis (DVT) or PE*
- Investigations for cancer
See the guideline in development page for progress on this update.
* The proposed update to pharmacological interventions is limited to anticoagulant treatments and does not include pharmacological thrombolysis or analgesia.
We checked this guideline in August 2018 following the publication of the pharmacomechanical catheter-directed thrombolysis for deep-vein thrombosis (ATTRACT) study. We found no new evidence that affects the recommendations of this guideline.
Guideline development process
How we develop NICE guidelines
Your responsibility
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.