Insights on management of recurrence of Cancer-associated isolated distal deep vein thrombosis

Isolated distal deep vein thrombosis (IDDVT) is the most prevalent form of deep vein thrombosis (DVT), comprising up to 50% of all DVT cases. The incidence of IDDVT varies depending on cancer type, patient-specific characteristics, and cancer treatment factors. Cancer-associated isolated distal deep vein thrombosis (CA-IDDVT) is a specific form of IDDVT, which has serious clinical outcomes, including death, VTE recurrence, and major bleeding. Despite its clinical importance, few studies have focused on the management of CA-IDDVT. Emerging evidence supports an individualized anticoagulation strategy, and extended-duration therapy is recommended. Notably, the ONCO-DVT trial demonstrates that extended treatment with edoxaban significantly reduces thrombotic risk without increasing major bleeding, highlighting its potential in CA-IDDVT management. This article reviews recent advances in the clinical factors, manifestations, and treatment strategies for CA-IDDVT, providing new insights to guide its effective management.