What do Judas Priest, surfing, and clots have in common? They are the passionate interests of expert Dr. Michael Streiff who guides us through the diagnosis and management of DVT and PE aka venous thromboembolism (VTE). By the end of the episode you will know how to catch a clot very Wells! We dive deep into the treatment options, literature, and some unique cases. ACP members can claim CME-MOC credit at https://acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by (including CME questions): Justin Berk MD, MPH, MBA Cover art by: Kate Grant MBChB DipGUMed Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Stuart Brigham MD Edited by: Matthew Watto, MD, FACP Guest:  Michael Streiff MD Time Stamps 00:00 Intro, disclaimer and guest bio 04:40 Guest one-liner, book and music recommendations, advice about rejection, how to think about studies 11:15 A case of DVT and some basic terminology 15:37 Which DVT risk factors are most important? 18:40 Use of the Wells score and D-dimer testing; should we use an age adjusted D-dimer; What about the YEARS criteria 22:55 Classifying DVT; determining need and duration of anticoagulation [distal (calf vein) DVT, proximal DVT]; brief discussion of IVC filters & catheter directed therapies 27:56 IVC filters for trauma 29:30 Upper extremity DVT 33:12 Proximal vs whole leg ultrasound for diagnosis of DVT 36:25 A case of pulmonary embolism; how to diagnose pulmonary embolism and a bit on V/Q scans 40:35 PESI score and HESTIA criteria 42:05 Summary of how to diagnose DVT and PE 43:34 Choice of initial anticoagulation 45:29 DOACs for cancer 48:14 DOACs for patients with very high or very low BMI 49:33 Why apixaban is Dr Streiff’s favorite DOAC? 51:20 Duration of therapy for DVT and PE 53:33 Unprovoked DVT/PE: Risk scoring models 57:52 Is thrombophilia workup necessary? 58:28 Antiphospholipid antibody syndrome 59:58 An extensive cancer workup is unnecessary 60:33 Subsegmental pulmonary embolism: To treat or not to treat 61:49 Apixaban dosing in CKD and ESRD 63:51 AUGUSTUS trial for dual versus triple therapy 64:52 Plug for National Blood Clot Alliance “Stop the Clot”; Anticoagulation Forum website; new 2019 ASH guidelines 66:35 Outro 68:00 Post credit scene