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This review outlines the complexities and therapeutic strategies for recurrent VTE in cancer patients, which includes distinguishing thrombus acuity, differentiating between tumor and bland thrombi, and evaluating potential contributing factors including anticoagulant adherence, extrinsic tumor compression, drug interactions, and anticoagulant-specific considerations such as heparin-induced thrombocytopenia or antithrombin deficiency. Different anticoagulation strategies are discussed, including the administration of escalated-dose low molecular weight heparin (LMWH) as well as the indications and rationale for switching between direct oral anticoagulants or LMWH.<\/jats:p>","DOI":"10.1182\/hematology.2024000552","type":"journal-article","created":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T15:02:48Z","timestamp":1733497368000},"page":"253-258","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":4,"title":["Trousseau syndrome: management of refractory VTE"],"prefix":"10.1182","volume":"2024","author":[{"given":"Jeffrey I.","family":"Zwicker","sequence":"first","affiliation":[{"name":"Department of Medicine, Hematology Service, Memorial Sloan Kettering Cancer Center, New York, NY; and Weill Cornell Medical College, New York, 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