Management of Venous Thromboembolic Disease with Dr. Lisa Moores

Published

In this episode of Curbside Consults, we discuss the recently published guidelines on the management of venous thromboembolic disease by the American College of Chest Physicians. We are joined by one of the guideline authors, Dr. Lisa Moores, Associate Dean for Assessment and Professor of Medicine at the Uniformed Services University of the Health Sciences in Bethesda, Maryland.

0:00 – Introduction
01:15 – Experience on guideline committee
03:05 – What’s new in these updated guidelines
04:30 – Review of VTE disease
05:28 – Management of DVT
09:07 – Risk stratification of PE: PESI score, ESC risk stratification
13:16 – Management of PE
17:34 – Anticoagulant choice in the setting of malignancy
20:10 – Who should avoid DOACs
22:32 – Duration of therapy
26:07 – Concluding remarks

Articles and resources discussed in this episode:

1. Stevens SM et al. Antithrombotic Therapy for VTE Disease: Second Update of the CHEST Guideline and Expert Panel Report. Chest 2021.
2. Meyer G et al. for the PEITHO Investigators. Fibrinolysis for Patients with Intermediate-Risk Pulmonary Embolism. N Engl J Med 2014.
3. Konstantinides SV et al. 2019 ESC Guidelines for the Diagnosis and Management of Acute Pulmonary Embolism. Eur Heart J 2020.
4. Pulmonary Embolism Severity Index (PESI)
5. Simplified PESI (Pulmonary Embolism Severity Index)
6. Agnelli G et al. for the Caravaggio Investigators. Apixaban for the Treatment of Venous Thromboembolism Associated with Cancer. N Engl J Med 2020.
7. Raskob GE et al. for the Hokusai VTE Cancer Investigators. Edoxaban for the Treatment of Cancer-Associated Venous Thromboembolism. N Engl J Med 2018.

The Curbside Consults series complements the foundational information in Rotation Prep by taking a deep dive into key clinical topics with expert clinicians and educators. These podcasts explore and critique the evidence behind clinical practice and break down statistical concepts for the busy clinical trainee.

 Lisa Moores, MD, FCCP, MACP, FRCP, is Associate Dean for Assessment and Professor of Medicine at the Uniformed Services University of the Health Sciences in Bethesda, Maryland.


 Leslie Chang, MD, is a 2021-2022 NEJM Editorial Fellow and a hospitalist at Massachusetts General Hospital. She graduated from Duke University School of Medicine in 2018 and completed her internal medicine residency at Massachusetts General Hospital in 2021.

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