To what extent should anticoagulation therapy be considered for venous malformations?

D-Dimer, fibrin, fibrinogen, thrombocytes, protein C, and protein S levels are commonly used laboratory tests for coagulopathy assessment among patients with venous malformations (VMs). Patients with VMs and symptomatic localized intravascular coagulopathy appear to benefit from anticoagulation. Rigorous anticoagulation prophylaxis is warranted for high-risk scenarios including hospitalizations and surgery. Given the paucity of data on the long-term effect of this recommendation and limited guidance for societal guidelines, the recommendations need to be patient centered and imply a clear presentation of the risks and benefits.