{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T17:20:29Z","timestamp":1788628829907,"version":"build-2803163510"},"reference-count":78,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T00:00:00Z","timestamp":1741305600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceutics"],"abstract":"<jats:p>Direct oral anticoagulants (DOACs) have emerged as the preferred oral anticoagulant therapy for patients with deep vein thrombosis of the lower extremities and pulmonary embolism. DOACs offer several advantages over vitamin K antagonists, including fixed dosage, fewer drug interactions, faster onset of action, and a lower risk of major bleeding, especially intracranial. Although evidence on the use of DOACs in unusual-site venous thrombosis (USVT) is limited, their use in such cases is becoming increasingly common. This narrative review examines the evidence derived from randomized controlled trials, and large observational studies focused on the use of the DOACs in USVT, including cerebral, splanchnic, upper extremity, ovarian, renal, and retinal vein thrombosis. In addition, it also provides practical advice for their use in these clinical settings according to the updated scientific literature.<\/jats:p>","DOI":"10.3390\/pharmaceutics17030342","type":"journal-article","created":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T04:29:59Z","timestamp":1741321799000},"page":"342","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Direct Oral Anticoagulants for the Treatment of Unusual-Site Venous Thrombosis: An Update"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1061-0200","authenticated-orcid":false,"given":"Anabel","family":"Franco-Moreno","sequence":"first","affiliation":[{"name":"Venous Thromboembolism Unit, Department of Internal Medicine, Hospital Universitario Infanta Leonor, Avenida Gran Via del Este, 80, 28031 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Madro\u00f1al-Cerezo","sequence":"additional","affiliation":[{"name":"Venous Thromboembolism Unit, Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Camino del Molino, 2, Fuenlabrada, 28942 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Mart\u00ednez-Casa-Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Hospital Universitario Gregorio Mara\u00f1\u00f3n, Calle del Dr. Esquerdo, 46, 28007 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Ortiz-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Venous Thromboembolism Unit, Hospital Universitario de Torrej\u00f3n, Calle Mateo Inurria, Torrej\u00f3n de Ardoz, 28850 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina Luc\u00eda","family":"Ancos-Aracil","sequence":"additional","affiliation":[{"name":"Venous Thromboembolism Unit, Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Camino del Molino, 2, Fuenlabrada, 28942 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e545","DOI":"10.1016\/j.chest.2021.07.055","article-title":"Antithrombotic Therapy for VTE Disease: Second Update of the CHEST Guideline and Expert Panel Report","volume":"160","author":"Stevens","year":"2021","journal-title":"Chest"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"4693","DOI":"10.1182\/bloodadvances.2020001830","article-title":"American Society of Hematology 2020 guidelines for management of venous thromboembolism: Treatment of deep vein thrombosis and pulmonary embolism","volume":"4","author":"Ortel","year":"2020","journal-title":"Blood Adv."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1055\/s-0040-1712913","article-title":"Venous Thromboembolic Diseases: Diagnosis, Management and Thrombophilia Testing: Observations on NICE Guideline [NG158]","volume":"120","author":"Schulman","year":"2020","journal-title":"Thromb. 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