Deep venous thrombosis (DVT) is a medical emergency requiring immediate anticoagulant treatment to prevent further clot formation and pulmonary thrombo-embolism. We present here the case of a patient affected by class I obesity who suffered from recurrent DVT despite anticoagulation with rivaroxaban.1 After a switch to VKA, it appeared that the patient also presented resistance to vitamin K antagonists (VKA). Through this case, we would like to highlight the factors that must be taken into account when initiating and monitoring an anticoagulation therapy, including obesity and VKA resistance.

(BELG J HEMATOL 2021;12(7):323–6)