What Wells DVT score thresholds guide management?

Two-level Wells: score ≤2 = DVT unlikely (D-dimer test, if negative = rule out DVT without US); score ≦3 = DVT likely (immediate compression ultrasound required); D-dimer not needed if Wells ≦3 (high pre-test probability).

What Wells DVT criteria assign points?

Active cancer +1; paralysis/paresis/immobilisation of lower extremity +1; bed rest ≥3 days or surgery within 4 weeks +1; localised tenderness along deep venous system +1; entire leg swollen +1; calf swelling >3 cm +1; pitting oedema +1; collateral superficial veins +1; previous DVT +1; alternative diagnosis as likely or more likely -2.

How long should anticoagulation continue for DVT?

Provoked DVT (major transient risk factor): 3 months minimum; unprovoked DVT: 6-12 months, then reassess; recurrent unprovoked VTE: indefinite anticoagulation; cancer-associated: 6 months minimum then reassess; active cancer: DOAC preferred over LMWH (ADAM VTE trial).

What superficial venous thrombosis requires treatment?

SVT ≥5 cm length or involving GSJ junction: fondaparinux 2.5 mg SC once daily for 45 days reduces DVT extension; SVT extending within 3 cm of GSJ: full therapeutic anticoagulation for 3 months to prevent PE.

What thrombophilia testing is indicated after DVT?

Testing after first unprovoked DVT: antiphospholipid antibodies (lupus anticoagulant, aCL, anti-β2GPI); factor V Leiden, prothrombin G20210A; protein C, protein S, antithrombin after stopping anticoagulation (3 months off); results change management in <5% of cases.

Wells Score for Deep Vein Thrombosis Probability

Calculates the Wells DVT probability score to guide D-dimer testing and lower limb compression ultrasound ordering for suspected deep vein thrombosis, with treatment duration guidance for provoked vs unprovoked DVT.

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Frequently Asked Questions

What Wells DVT score thresholds guide management?

What Wells DVT criteria assign points?

How long should anticoagulation continue for DVT?

What superficial venous thrombosis requires treatment?

What thrombophilia testing is indicated after DVT?