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In patients who are given anticoagulation for distal deep venous thrombosis (DVT) of the lower extremity (i.e., calf DVT), a 3-month course is recommended (Chest 2021; 160:2247). Investigators assessed long-term risk for venous thromboembolism (VTE) recurrence and initial bleeding risk in 475 Norwegian patients who presented with first calf DVT and received 3 months of anticoagulation.
During average follow-up of 5 years (maximum, 15 years), 1-, 5-, and 10-year risk for VTE recurrence was 6%, 15%, and 27%, respectively; nearly two thirds of recurrences were pulmonary embolism or proximal DVTs. Unprovoked calf DVT (compared with provoked calf DVT) was associated with a higher rate of recurrent VTE (40% vs. 20% at 10 years). When the provoking…