Key risks associated with the management of isolated distal deep vein thrombosis and supporting levels of evidence
| Associated complication | Estimated risk | Level of evidence |
|---|---|---|
| With conservative management | ||
| Fatal bleeding | 0% | 1− |
| Major bleeding | 0% | 1− |
| Propagation to the popliteal trifurcation or above | 9.1% (95% CI 7.1% to 10.6%) | 1− |
| Acute pulmonary embolism | 3.2% (95% CI 0.9% to 5.5%) | 1− |
| All-cause mortality | 0.9% (95% CI 0% to 2.3%) | 1− |
| With therapeutic anticoagulation | ||
| Fatal bleeding | 0.37% (95% CI 0.36% to 0.38%) | 1++ |
| Major bleeding | 2.06% (95% CI 2.04% to 2.08%) | 1++ |
| Propagation to the popliteal trifurcation or above | 1.6% (95% CI 0.1% to 3.0%) | 1− |
| Acute pulmonary embolism | 0% | 1− |
| All-cause mortality | 0.7% (95% CI 0% to 2.0%) | 1− |
Estimates from the literature4 ,35–37 are presented for 3/12 follow-up rates with CIs. Levels of evidence are graded as per the Scottish Intercollegiate Guideline Network recommendations. Bleeding estimates are based on the use of phased anticoagulation and oral vitamin K antagonists only. Major bleeding episodes are standardised as per the definition provided by the International Society for Thrombosis and Haemostasis.74