ESVS 2025 Guidelines

For mesenteric venous thrombosis (MVT), immediate anticoagulation is indicated, with low-molecular-weight heparin (LMWH) recommended as first-line therapy in the acute phase [@esvs2025].per the European Society for Vascular Surgery (ESVS) guidelines [@esvs2025; @esvs2025-editors]. Following the acute phase, direct oral anticoagulants (DOACs) may be considered as an alternative to vitamin K antagonists (VKAs) for long-term treatment in patients without malignancy or cirrhosis [@esvs2025-editors]. Invasive therapytherapy, (includingincluding catheter-directed thrombolysis (CDT) or mechanical thrombectomy)thrombectomy, should be considered in patients with clinical deterioration or signs of bowel ischemia despite anticoagulation [@esvs2025]. Evaluation for underlying provoking factorsfactors, (includingincluding thrombophiliathrombophilia, malignancy, and malignancy)specifically myeloproliferative neoplasms (MPN) via Janus kinase 2 (JAK2) mutation screening, is recommended.recommended [@esvs2025-editors]. Anticoagulation is generally continued for at least 6 months, with extended or indefinite therapy considered for unprovoked MVT or persistent risk factors after individualized bleeding-risk assessment [@esvs2025].[@esvs2025; @esvs2025-editors].