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Venous thromboembolic diseases: diagnosis, management and thrombophilia testing

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Last updated:25th Mar 2020
Venous thromboembolic diseases: diagnosis, management and thrombophilia testing - NICE guideline

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.

Venous thromboembolism (VTE) is a condition in which a blood clot (a thrombus) forms in a vein, most commonly in the deep veins of the legs or pelvis. This is known as deep vein thrombosis, or DVT. The thrombus can dislodge and travel in the blood, particularly to the pulmonary arteries. This is known as pulmonary embolism, or PE. The term 'VTE' includes both DVT and PE.

Venous thromboembolic diseases cover a spectrum ranging from asymptomatic calf vein thrombosis to symptomatic DVT. They can be fatal if they lead to PE, in which the blood supply to the lungs is badly blocked by the thrombus. Non-fatal VTE can cause serious long-term conditions such as post-thrombotic syndrome.

Thrombophilia is a major risk factor for VTE. It is an inherited or acquired prothrombotic state that predisposes to VTE. Other major risk factors for VTE include a history of DVT, age over 60 years, surgery, obesity, prolonged travel, acute medical illness, cancer, immobility and pregnancy.

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