Table 4.

How I evaluate and treat patients with SCD with VTE

Diagnosis	Little utility to D-dimer
	Compression ultrasonography (±Doppler) for deep venous thrombosis
	Computed tomography angiography with nonionic low-osmolality contrast media
	I do not routinely give red cell transfusion before contrast
	As with the general population, V/Q scans now rarely performed
Therapy	Treatment as per American College of Chest Physicians 2016 guidelines with full-dose anticoagulation
	Caution in patients with history of ischemic stroke at risk for moyamoya syndrome
	Consider extended anticoagulation in those with low bleeding risk even if the event was provoked by hospitalization for medical illness
	Continue anticoagulation for catheter-associated upper extremity thrombosis until catheter removal
	No convincing evidence to support primary prophylaxis for those with a catheter and no history of thrombosis
	I do not recommend primary thromboprophylaxis for pregnant patients with sickle cell who have never had a VTE
	Low molecular weight heparin during pregnancy and 6 wk postpartum for a patient with any prior VTE (if catheter-related, only if the catheter in still in place)