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Module 7: Treatment Duration

Determine optimal anticoagulation duration based on provoked versus unprovoked PE, cancer, antiphospholipid syndrome, and other persistent risk factors.

Pre-Test Prob.D-Dimer Severity (PESI)Category (A–E)Hestia Criteria Anticoagulation Duration Advanced Rx Special Populations

Treatment Duration Risk Classification

Source: 2026 AHA/ACC PE Guideline, Section 5.2, Table 8. Select the primary risk factor.

Major Reversible Risk Factor (Provoked PE)Class I / Level B-NR

Surgery, major trauma, or immobilization ≥3 consecutive days within 3 months of PE

3–6 months

Unprovoked PEClass I / Level A

No identifiable reversible or persistent risk factor for thrombosis

Extended (>6 months)

Persistent Risk FactorClass I / Level C-LD

Antiphospholipid syndrome, chronic autoimmune disease, ongoing thrombophilic state

Extended (until resolved)

Active CancerClass I / Level A

Active malignancy under treatment or in palliative phase

Extended (≥6 months, indefinite)

Select a risk factor category above to see the duration recommendation.

Duration Reference — 2026 AHA/ACC PE Guideline, Table 8

Risk Category	Duration	Strength
Major reversible (provoked)	3–6 months	Class I / Level B-NR
Unprovoked	>6 months (extended)	Class I / Level A
Persistent risk factor	Extended (until resolved)	Class I / Level C-LD
Cancer-associated VTE	≥6 months; indefinite	Class I / Level A
Reduced-dose extended (Apia 2.5 / Riva 10)	After initial 6 mo	Class IIa / Level B-R

IMPORTANT: This software is clinical decision support (CDS) intended for use by licensed healthcare professionals under Section 520(o)(1)(E) of the Federal Food, Drug, and Cosmetic Act. It is not intended as a medical device. All recommendations are derived from the 2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN Guideline for the Evaluation and Management of Acute Pulmonary Embolism (Circulation 2026;153:e977-e1051) and must be independently verified by the treating clinician before any clinical action. AI-generated content (including extracted data and clinical notes) is produced by large language models and may contain errors, omissions, or hallucinations — clinician review is mandatory. Patient data entered into the calculator is processed entirely in the browser; AI features process data server-side under a signed HIPAA Business Associate Agreement with no data retention. AI-HEART Lab, its affiliates, and contributors assume no liability for clinical decisions made using this tool. By using this tool, you acknowledge these limitations and accept full responsibility for clinical decisions.