Management and Prevention of Deep Vein Thrombosis in Endurance Athletes: A Systematic Review
DOI:
https://doi.org/10.12775/QS.2026.69.74434Keywords
deep vein thrombosis, venous thromboembolism, endurance athletes, anticoagulant therapy, thromboprophylaxis, return to sportAbstract
Background: Venous thromboembolism (VTE) may also occur in highly trained individuals. In endurance athletes, diagnosis may be challenging because symptoms can resemble sports injuries or overuse conditions, while management must account for return to training and the risk of bleeding during anticoagulation.
Aim: This review aimed to synthesise the evidence on the pathophysiology, risk factors, diagnosis, treatment, and prevention of deep vein thrombosis (DVT) in endurance athletes.
Materials and methods: The review was conducted and reported in accordance with PRISMA 2020. PubMed and Scopus were searched for English-language publications dated from 1 January 2016 to 12 July 2026.
Results: A total of 139 records were identified. After 19 duplicates had been removed, 120 titles and abstracts were screened. Nineteen reports underwent eligibility assessment; five were excluded and 14 were included in the narrative synthesis. The evidence consisted mainly of case reports and small observational studies. Sports-related exposures most frequently coexisted with anatomical, inherited, or acquired risk factors. Diagnosis and initial treatment did not differ substantially from management in the general population, whereas decisions regarding invasive treatment and return to sport required individualisation. No evidence was identified to support routine pharmacological thromboprophylaxis in all healthy athletes.
Conclusions: DVT in endurance athletes is a multifactorial event, and population-specific evidence remains limited. Early recognition, identification of reversible and anatomical risk factors, guideline-based treatment, and individualised plans for prevention and return to training are essential.
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