title: Controversies in venous thromboembolism: the unique case of isolated distal deep vein thrombosis.
abstract: Venous thromboembolism (VTE) represents the third leading cause of cardiovascular mortality, and it is the main cause of preventable mortality in hospitalized patients. Among VTE, there is the unique case of isolated distal deep vein thrombosis (IDDVT), which still lacks an agreement in terms of optimal therapeutic strategy. Although most IDDVTs are self-limiting and associated with a very low risk of embolic complications, still not all IDDVTs can be safely identified as stable. Lack of strong scientific evidence, fear of thromboembolic complications, and risk of bleeding upon initiation of anticoagulant treatment result in very heterogeneous therapeutic strategies among physicians. Here, we provide a comprehensive review of the literature, highlight the many controversial issues regarding IDDVTs, and call for a consensus of experts aimed to shed new light on the gray areas of IDDVT management and therapy.
authors.affiliation: Division of Internal Medicine and Vascular Diseases, Department of Medicine, A. Gemelli University Hospital, Catholic University School of Medicine, Largo Agostino Gemelli 8, 00168, Rome, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Porfidia
authors.affiliation: Division of Internal Medicine and Vascular Diseases, Department of Medicine, A. Gemelli University Hospital, Catholic University School of Medicine, Largo Agostino Gemelli 8, 00168, Rome, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Carnicelli
authors.affiliation: Division of Internal Medicine and Vascular Diseases, Department of Medicine, A. Gemelli University Hospital, Catholic University School of Medicine, Largo Agostino Gemelli 8, 00168, Rome, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Bonadia
authors.affiliation: Division of Internal Medicine and Vascular Diseases, Department of Medicine, A. Gemelli University Hospital, Catholic University School of Medicine, Largo Agostino Gemelli 8, 00168, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Pola
authors.affiliation: Division of Internal Medicine and Vascular Diseases, Department of Medicine, A. Gemelli University Hospital, Catholic University School of Medicine, Largo Agostino Gemelli 8, 00168, Rome, Italy. raffaele.landolfi@unicatt.it.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Landolfi
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000453:epidemiology / Q000628:therapy*; D020246:Venous Thrombosis / Q000453:epidemiology / Q000628:therapy*
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight
keywords: Anticoagulant; Calf thrombosis; IDDVT; Isolated distal deep vein thrombosis