Deep Vein Thrombosis practice

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Cardiovascularmiddle twist

A 66-year-old man with metastatic gastric adenocarcinoma develops a symptomatic proximal deep vein thrombosis. He has a friable gastric lesion with recent occult blood loss, but is haemodynamically stable and has normal renal function. He has not previously received anticoagulation. Which one of the following is the most appropriate initial treatment?