Borders Ref Help Toolkit
Who to refer:
- Unprovoked lower limb DVT or PE <45years.
- Thrombosis at an unusual site unless clearly provoked by local surgery / infection e.g. mesenteric vein, portal vein, CVST
- Thrombosis prone individuals with family history of unprovoked/weakly provoked VTE in first degree relatives <50years old.
- Pregnant women at risk of venous thrombosis:
- Preconception or pregnancy advice for those with a personal or family history of thrombosis
- Preconception or pregnancy advice for those on warfarin or DOACS
- Patients with a first degree relative with known antithrombin deficiency, protein C or protein S deficiency.
Who not to refer:
- First episode VTE >45 years.
- History of strongly provoked VTE only at any age
- Central venous catheter related thrombosis
- Retinal vein occlusion
- Asymptomatic relatives of patients with antiphospholipid antibody syndrome, as this is an acquired disorder
- Women seeking to use oestrogen containing medications (COCP, HRT) in whom there is already a personal or family history leading to a contra-indication or serious caution for use
- Any patient with arterial thrombosis (unless suspicion of paradoxical embolism e.g. young stroke with proven PFO).
How to refer:
SCI gateway to the Department of Haematology BGH