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Updated: May 22, 2026

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Published on: February 10, 2023

Contemporary management of pediatric venous thrombosis: how does it differ from adult care?

Alexandra Zabeida1, Hui Yin Lim2, Amy L Kiskaddon3

  • 1Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine - Université de Montréal, Montréal, Québec, Canada.

Journal of Thrombosis and Haemostasis : JTH
|May 20, 2026
PubMed

Insights

Pediatric venous thromboembolism (VTE) management is unique due to age-specific factors. Updated guidelines offer tailored VTE care for children, differing from adult protocols.

Area of Science:

  • Hematology
  • Pediatric Medicine
  • Thrombosis Research

Background:

  • Pediatric venous thromboembolism (VTE) management requires distinct approaches compared to adults, considering developmental hemostasis and unique clinical scenarios.
  • Historically, pediatric VTE treatment relied on adult data, but recent guidelines provide evidence-based, age-specific recommendations.
  • Pediatric VTE is often provoked by factors like central venous catheters or surgery, unlike the unprovoked or cancer-associated VTE common in adults.

Purpose of the Study:

  • To review contemporary management strategies for pediatric venous thromboembolism (VTE).
  • To highlight key differences between pediatric and adult VTE care.
  • To emphasize the role of anticoagulation stewardship programs in pediatric VTE management.

Main Methods:

  • Review of updated American Society of Hematology and International Society on Thrombosis and Haemostasis pediatric VTE guidelines.
  • Comparison of pediatric VTE risk factors, presentation, and treatment modalities with adult VTE.
  • Discussion of current anticoagulation options, including direct oral anticoagulants and parenteral agents.
  • Emphasis on treatment duration and imaging-guided reassessment in pediatric VTE.

Main Results:

  • Updated pediatric VTE guidelines offer tailored, evidence-based recommendations distinct from adult care.
  • Direct oral anticoagulants are increasingly used in pediatrics, alongside established parenteral anticoagulants.
  • Pediatric VTE management emphasizes shorter treatment courses for provoked events and imaging guidance.
  • Dedicated pediatric anticoagulation stewardship programs are crucial for safety, dosing, and transitions of care.

Conclusions:

  • Pediatric VTE management necessitates specialized strategies due to age-specific factors and differs significantly from adult care.
  • Adherence to updated guidelines and implementation of anticoagulation stewardship programs can optimize pediatric VTE treatment.
  • Shared decision-making is vital for high-quality thrombosis care across all age groups.

Keywords:
anticoagulantschildthrombosis

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