Diagnosing the “Second Clot”: Lessons from PREDICTORS with Dr Vicky Mai and Dr Grégoire Le Gal

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Diagnosing recurrent venous thromboembolism (VTE) remains one of the biggest clinical challenges in thrombosis medicine. In this episode, Dr. Vicky Mai and Dr. Grégoire Le Gal join us to discuss the international PREDICTORS study (JTH, 2025), which evaluated the performance of commonly used clinical decision rules (Wells and Geneva scores) in patients with suspected recurrent VTE. They share why symptoms can be misleading, how residual clots complicate imaging, and what their findings mean for the safe use of D-dimer and anticoagulation status in clinical practice.

Reference:

Mai, V., Martens, E. S., Righini, M., Schulman, S., Thiruganasambandamoorthy, V., Kahn, S. R., ... & Le Gal, G. (2025). Performance of clinical decision rules in patients presenting with suspected recurrent venous thromboembolism: a multicenter prospective cohort study. Journal of Thrombosis and Haemostasis.

https://www.sciencedirect.com/science/article/abs/pii/S1538783625004088

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