venous thromboembolism

ASH Releases New VTE Guidelines

The American Society of Hematology (ASH) has released new guidelines on the prevention, diagnosis, and management of venous thromboembolism (VTE).


The guidelines, of which 6 of a total 10 chapters have now been published in the journal Blood Advances, are the product of the collaborative effort of both ASH and the McMaster University GRADE Centre.


“In recent years, a tremendous body of evidence has been generated to guide prevention, diagnosis, and treatment of VTE, yet approaches are often applied inconsistently. The 2018 ASH guidelines took the latest evidence into account to make recommendations that in some instances will reinforce existing best practices and in other instances will change practice,” said Adam Cuker, MD, MS, Chair, ASH VTE Guidelines Coordination Panel and HIT Panel and Clinical Director of the Penn Blood Disorders Center and Director of the Penn Comprehensive and Hemophilia Thrombosis Program, University of Pennsylvania in Philadelphia.


The 6 published chapters of the guidelines cover prophylaxis, diagnosis, optimal management of anticoagulation therapy, heparin-induced thrombocytopenia, VTE and pregnancy, and pediatric VTE. The 4 remaining chapters will focus on deep-vein thrombosis and pulmonary embolism, VTE and cancer, thrombophilia, and prevention of VTE in surgical patients, and are expected to be published in 2019.


Among the over 200 recommendations:

  • Anticoagulants are preferred over mechanical prophylaxis in hospitalized patients with high VTE risk and acceptable bleeding risk.
  • Patients stopping warfarin to undergo invasive procedures do not need bridge therapy.
  • Many patients who experience major bleeding during anticoagulation therapy should resume therapy following recovery.

“ASH believes it is essential to provide updated treatment guidelines that reflect this increased knowledge and can help the medical community better prevent, diagnose, and treat VTE,” Cuker concluded.


—Michael Potts



ASH releases new clinical practice guidelines for venous thromboembolism [press release]. American Society of Hematology. Washington, DC. November 27, 2018.