Archive for the ‘Venous Clots’ Category
Stephan Moll, MD writes… An article for patients discussing (a) IVC filters, (b) narrowing of the main left pelvic vein (May-Thurner syndrome) and (c) pelvic venous stents has just been published (http://circ.ahajournals.org/content/133/6/e383.full.pdf). Color images of anatomy, filters and stents are included as visual aids. The article may be helpful as handout material for patients in clinic.
Reference: Carroll S, Moll S. Circulation. 2016;133:e383-e387
Last updated: Feb 18th, 2016
Stephan Moll, MD writes… An information article on various aspects of thrombophilia, written for patients and family members, was published today – available here – as a Vascular Disease Patient Information Page in the journal Vascular Medicine. It addresses (a) in which patient with venous thromboembolism to consider thrombophilia testing, (b) what tests might be appropriate to do, (c) how the test results might influence length of anticoagulation therapy (d), what contraceptives are safe to use in women with a history of DVT or PE or thrombophilia, and (e) in which family members to consider thrombophilia testing. This article can be used as an education handout for patients in clinic or the hospital who have DVT, PE, venous thrombosis in unusual locations, or an established thrombophilia.
Last updated: April 1st, 2015
Stephan Moll, MD writes (Dec 17, 2014)… The American Society of Hematology (ASH) published last week as part of its Choosing Wisely® campaign two things that physicians dealing with DVT, PE and anticoagulants should avoid [ref 1]. Read the rest of this entry »
Stephan Moll, MD writes… This week (Feb 18th, 2014) a guidance document on the prevention and management of catheter-associated upper extremity (brachial, axillary, subclavian, and brachiocephalic veins) and neck (internal jugular) DVT was published by the International Society for Thrombosis and Haemostasis (ISTH) [ref 1]. The authors acknowledge that optimal long-term management of catheter-associated DVT has not been established. The key recommendations: Read the rest of this entry »
Stephan Moll, MD writes… Patients who are on warfarin for a history of DVT or PE may inquire whether a switch to one of the new oral anticoagulants is appropriate. Similarly, many physicians initiate this discussion with their patients.
This is, obviously, a detailed discussion and an individualized decision with a number of factors to be considered. We have developed a two-page “Comparison of Oral Blood Thinners” handout for patients, to assist with and summarize the discussion. This sheet allows a structured discussion with the patient about the pros and cons of the various anticoagulant choices. The reader is welcome to print this resource and use it as a handout for his/her patients.
Disclosure: I have been a consultant for Boehringer-Ingelheim, Daiichi, and Janssen.
Last Updated: Dec 19th, 2013
Stephan Moll, MD writes…
On Oct 8th, 2013 the FDA approved Adempas® (riociguat), a new oral drug to treat pulmonary hypertension. The drug is a guanylate cyclase stimulator that leads to arteries dilatation. It is intended for:
- Patients with chronic thromboembolic pulmonary hypertension (CTEPH) Read the rest of this entry »
Stephan Moll, MD writes… A major international coagulation conference, the bi-annual meeting of the International Society for Thrombosis and Haemostasis (ISTH; www.isth.org), took place in Amsterdam, Holland, from June 29th to July 4th, 2013. The clinically relevant highlights about thrombosis and anticoagulation are summarized below. Read the rest of this entry »
Stephan Moll, MD writes…
An important study (AMPLIFY trial) was published today in the New England Journal of Medicine [ref 1]: In a large study of 5395 patients with acute DVT or PE, Eliquis (apixaban) was as effective as warfarin and caused less major bleeding. Read the rest of this entry »
Stephan Moll writes…
2012 has been a year with significant progress in the field of venous thromboembolism and anticoagulation. The three most noteworthy, clinically relevant developments were probably (a) the publication of the new ACCP (American College of Chest Physician) guidelines on antithrombotic therapy in February 2012; (b) The FDA-approval of rivaroxaban (Xarelto) in November 2012 for the acute treatment of venous thromboembolism (VTE) and long-term secondary prevention; and (c) The FDA-approval of apixaban (Eliquis) in December 2012 for atrial fibrillation and the prevention of arterial thromboembolism. Here I have listed and summarized the 10 top publications of 2012 in the field of venous thromboembolism and anticoaguation as I see them – the ones clinically most relevant.
Disclosure: I have consulted for Janssen, Boehringer-Ingelheim and Daiichi.
Last updated: Feb 7th, 2013
Stephan Moll, MD writes…
The CDC published an alert on Oct 26th, 2012, that they are investigating 12 cases of TTP (thrombotic thrombocytopenic purpura) in drug users who injected intravenously the opioid pain medication Opana ER® (oxymorphone extended-release), a medication made as a tablet and meant for oral use. The tablet was pulverized by the drug users to allow i.v. injection (detailed CDC alert here).
Relevance for clinicans involved in the care of patients with TTP: Inquire in the history taking about drug abuse and injection of Opana ER.
Last updated: Oct 29th, 2012