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A Delphi method was used, consisting of 4 rounds of voting and subsequent discussions. The panel included 18 international experts from 11 countries and 4 continents. Consensus was defined as \u226575% agreement among participants. Recommendations were structured into the following categories: thromboprophylaxis, perioperative management, and VTE treatment. Consensus was reached on several critical areas, resulting in 14 recommendations. Key recommendations include: thromboprophylaxis should be considered at time of CS diagnosis and continued for 3 months after biochemical remission, provided there are no obvious contraindications. The standard weight-based prophylactic dose of low molecular\u2013weight heparin is the preferred agent for thromboprophylaxis in patients with CS. Additionally, perioperatively and around inferior petrosal sinus sampling, thromboprophylaxis should be reconsidered if not already initiated at diagnosis. For VTE treatment, extended thromboprophylaxis is advised continuing for 3 months after Cushing is resolved. These Delphi consensus-based recommendations aim to standardize care practices and enhance patient outcomes in CS by providing guidance on thromboprophylaxis, including its initiation and continuation across various disease states, as well as the preferred agents to use. The panel also highlighted key areas for further research, particularly regarding the use of direct oral anticoagulants in CS and the management of mild CS and mild autonomous cortisol secretion. Additionally, the optimal duration of anticoagulant prophylaxis following curative treatment remains uncertain.<\/jats:p>","DOI":"10.1093\/ejendo\/lvaf017","type":"journal-article","created":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T07:27:54Z","timestamp":1738826874000},"page":"R17-R27","source":"Crossref","is-referenced-by-count":22,"title":["Delphi panel consensus on recommendations for thromboprophylaxis of venous thromboembolism in endogenous Cushing's syndrome: a position statement"],"prefix":"10.1093","volume":"192","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1817-4597","authenticated-orcid":false,"given":"Kristina","family":"Isand","sequence":"first","affiliation":[{"name":"Institute of Biomedicine and Translational Medicine, University of Tartu, \u00dclikooli 18, 50090 Tartu ,","place":["Estonia"]},{"name":"Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford University Hospitals, OX37LE Oxford, United Kingdom"},{"name":"Department of Endocrinology,East-Tallinn Central Hospital , Ravi 18, 10138 Tallinn ,","place":["Estonia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Arima","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine , 464-8601 Nagoya ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerome","family":"Bertherat","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, National Reference Center for Rare Adrenal Disorders, H\u00f4pital Cochin, Assistance Publique H\u00f4pitaux de Paris, Universit\u00e9 Paris-Cit\u00e9 , F-75014 Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1333-7580","authenticated-orcid":false,"given":"Olaf M","family":"Dekkers","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center , 2333 ZA Leiden ,","place":["The Netherlands"]},{"name":"Department of Clinical Epidemiology, Leiden University Medical Center , 2333 ZA Leiden ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A","family":"Feelders","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Endocrinology, Erasmus Medical Center , 3015 GD Rotterdam ,","place":["The Netherlands"]},{"name":"Division of Endocrinology, Diabetes and Metabolism, New York University Langone Medical Center , New York, NY 10016 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9284-6289","authenticated-orcid":false,"given":"Maria","family":"Fleseriu","sequence":"additional","affiliation":[{"name":"Department of Medicine, Pituitary Center, Oregon Health & Science University , Portland, OR 97239 ,","place":["United States"]},{"name":"Department of Neurological Surgery, Pituitary Center, Oregon Health & Science University , Portland, OR 97239 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica R","family":"Gadelha","sequence":"additional","affiliation":[{"name":"Medical School and Hospital Universit\u00e1rio Clementino Fraga Filho, Universidade Federal do Rio de Janeiro , 21941-617 Rio de Janeiro ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Miguel","family":"Hinojosa-Amaya","sequence":"additional","affiliation":[{"name":"Pituitary Clinic, Endocrinology Division, Department of Medicine, Hospital Universitario \"Dr. Jos\u00e9 E. 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