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The optimal duration of anticoagulation for patients with deep venous thrombosis (DVT) is not clear. Italian investigators randomized 538 patients with DVT (306 unprovoked) to fixed or flexible continuation of anticoagulation; all patients had completed 3 months of anticoagulation before enrollment. The fixed-duration protocol involved 3 additional months of treatment for those with unprovoked DVT and none for those with secondary DVT. The flexible-duration protocol involved additional 3-month treatment courses until ultrasound showed recanalized veins (as long as 21 months for unprovoked DVT and 9 months for secondary DVT). Patients were excluded if they had had prior DVT, immobilization, or anticoagulant deficiencies.
During 33 months of f…