残余静脉阻塞(RVO)被认为是深静脉血栓形成(DVT)后复发以及其他可能的临床结局的风险因素。目前的指南不支持针对RVO的抗凝药物治疗持续时间;这种治疗策略的当代数据很少。我们旨在评估以RVO为基础的管理策略，并评估RVO与复发、后栓塞性综合征（PTS）、动脉事件和癌症之间的关联。为了获得更深入的见解，我们在停止抗凝药物治疗后一个月测量了D-二聚体水平。在马斯特里赫特大学医学中心，我们对有症状的近端DVT的连续患者进行了为期两年的临床护理路径（CCP）治疗，并对其进行了长达5年的随访。在常规的抗凝药物治疗期结束时，RVO被评估，并且如果检测到RVO，则延长治疗期。该研究已获得医疗伦理委员会的批准。在825名患者中，有804名患者（97.5％）完成了CCP，并有755名患者（93.9％）接受了长期随访。大多数患者（76.5％）停止了抗凝药物治疗。复发、PTS、动脉事件和癌症的发生率分别为100位患者年4.4、11.9、1.7和1.8。RVO与PTS（HR 1.66 [1.19-2.32]）和动脉事件（HR 2.07 [1.18-3.65]）独立相关，但与复发或癌症无关。高D-二聚体与复发有关（HR 3.51 [2.24-5.48]）。我们的基于RVO的管理策略可能已经减轻了RVO与复发之间的关联。此外，RVO可以识别出增加PTS和动脉事件风险的患者，这可能用于识别需要替代性治疗策略的患者。

Residual venous obstruction (RVO) is considered a risk factor of recurrence and possibly other clinical outcomes following deep vein thrombosis (DVT). Current guidelines do not support an RVO-tailored duration of anticoagulant therapy; contemporary data of such management strategies are scarce. We aimed to evaluate an RVO-based management strategy and to assess associations of RVO with recurrence, post-thrombotic syndrome (PTS), arterial events and cancer. To gain further insight, D-dimer levels were measured one month after stopping anticoagulant therapy. Consecutive patients with symptomatic, proximal DVT were treated in a two-year clinical care pathway (CCP) at Maastricht University Medical Center and were followed up to 5 years. RVO was assessed at the end of regular duration of anticoagulant therapy, which was extended once if RVO was detected. The study was approved by the medical ethics committee. From a total of 825 patients, 804 patients (97.5%) completed the CCP and 755 (93.9%) were available for extended follow-up. Most patients (76.5%) stopped anticoagulant therapy. Incidence rates of recurrence, PTS, arterial events and cancer were 4.4, 11.9, 1.7 and 1.8 per 100 patient-years, respectively. RVO was independently associated with PTS (HR 1.66 [1.19-2.32]) and arterial events (HR 2.07 [1.18-3.65]), but not with recurrence or cancer. High D-dimer was associated with recurrence (HR 3.51 [2.24-5.48]). Our RVO-based management strategy might have attenuated the association of RVO with recurrence. In addition, RVO identified patients at increased risk of PTS and arterial events, which might be used to identify patients in need of alternative treatment strategies.The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).