Would you recommend indefinite or extended anticoagulation in any scenario of a provoked clot?

The answer, like most decisions with the duration of anticoagulation after a VTE, is it depends.

The provoking factor is key to determining whether anticoagulation continuing beyond the treatment of the acute event is needed. If the provoking factor was a joint replacement surgery, even in the presence of these other risk factors (male sex, BMI >50), indefinite anticoagulation is likely not needed, but providing the patient with prophylactic anticoagulation during periods of future high risk (immobilization, surgery, travel, etc) would be reasonable.

However, if the provoking risk factor is on the weaker side, such as a history of a road trip prior to the clot, this would sway towards assessing for the presence of an inherited thrombophili...