Testing and Thrombotic Prophylaxis of Factor V Leiden Patients in the Primary Care Setting

Authors

• Grant DeCastillia, University of LynchburgFollow

Specialty

Hematology

Advisor

Dr. Tom Colletti

Abstract

This article examines appropriate management of patients with Factor V Leiden (FVL), with an emphasis on indications for screening and the role of thrombotic prophylaxis. A literature review was conducted through Google Scholar to identify a consensus and produce a guideline for the proper screening and treatment of FVL. Routine screening of the general population is not recommended. FVL testing should be considered only when results would alter clinical management, such as in patients considering estrogen replacement therapy or combined oral contraceptives. Men and patients experiencing transient acquired risk factors generally should not be tested for FVL except for rare occasions such as the first clot at a young age or thrombosis in an unusual location. Anticoagulation protocols for prevention and treatment of acute thrombosis should not change depending on FVL carrier status. Although anticoagulation reduces thrombotic risk in pregnancy, no treatment has consistently been shown to prevent undesired obstetric complications for FVL patients. Individualized assessment of thrombotic risk factors and family history remains essential to guide testing and/or management decisions.

Recommended Citation

DeCastillia G. Testing and Thrombotic Prophylaxis of Factor V Leiden Patients in the Primary Care Setting. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2026; 8(1).