I have two questions regarding the management of VTE.
- Most guidelines these days suggest avoiding unnecessary thrombophilia screens in unprovoked VTE, especially if it is the first occurrence and in the absence of a strong family history of clots. I am interested to know if and when thrombophilia screens including screening for occult malignancies are being done.
- Also, in the context of an provoked VTE due to malignancy recommendation are to treat with anticoagulation for as long as there is an active cancer. What then happens once this patient has achieved remission status with at least 3-6 months of therapeutic anticoagulation - should we be continuing therapeutic doses of therapy, switching to prophylaxis instead or stopping it altogether?
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