Hemostasis/Thrombosis   

Questions discussed in this category



How would the approach differ if the patient had a significant bleeding phenotype vs only minor bruising and mucosal bleeding?

In the absence of a VTE would you consider prophylaxis after a surgical procedure? Often non-hematologists order this testing but we are consulted for...

FVL heterozygotes are often treated similarly to the general population. Aside from avoiding other VTE risk factors, are there situations where prophy...

How does cirrhosis and/or underlying thrombophilia affect your decision?

Conversion tables suggest starting the new drug with the next dose but do not seem to answer this question (i.e. if switching from rivaroxaban 20 mg d...

In the setting of no personal or family history and no other risk factors for thrombosis, is systemic anticoagulation warranted if local treatments (e...

Would you offer indefinite anticoagulation if the event is unprovoked and the patient has low bleeding risk? 

Please also discuss the type and duration of anticoagulation.

Provoked or unprovoked VTE: Do you use D-Dimer (or even repeat imaging to reassess residual clot) in any capacity to guide anticoagulation duration? E...

Have you used anticoagulants other than coumadin? Or is that the only appropriate agent given monitoring is based on PT/INR?

Do you feel comfortable with BTK inhibitors in these patients? In ELEVATE-RR patients on a/c were excluded, and rate of atrial fibrillation in the ac...

While low-dose aspirin for primary thrombosis prevention in aPL without APS is not typically recommended outside cardiovascular prevention guidelines ...

While there are many factors involving:- type (DVT vs PE, unprovoked vs provoked) and severity of venous thromboembolism (VTE) size- duration of antic...

While follow up ultrasound is not usually recommended in provoked DVT, it often is done either for other reasons or by other physicians. Would this in...

While this is a known risk factor for venous [Meijers et al NEJM 2000] and potentially arterial [Yang et al, Am J Clin Pathol 2006] thrombosis, it is ...

Do you recommend therapeutic phlebotomy to a certain Hct goal? Any strong evidence for thromboembolic risk related to erythrocytosis or if this is mit...

Given recent data in Blood (Moik et al, 2021), and the potentially overlapping risks with other clinical factors associated with NSCLC. Will you alte...

Is there any difference between anticoagulants in this clinical context (e.g. anti-Xa inhibitors vs warfarin vs LMWH)?

The use of anti-fibrinolytics is typically contraindicated in DIC, but does it have benefit in DIC states characterized by hyperfibrinolysis?

Does having a concurrent consumptive process e.g. DIC change your management? 

- Dialysis catheter used for hemodialysis- RIJ thrombus in dialysis catheter was incidentally found- Patient asymptomatic with no prior history of VTE...

Assuming the patient is a candidate for all anticoagulation options (no mechanical valve, antiphospholipid syndrome, patient-specific contraindication...

While thrombophilia testing is not routinely recommended prior to starting OCPs, how about after the development of a VTE?

While the CKD population is at high thrombotic and bleeding risk, would you consider anticoagulating a patient prophylactically if they had a history ...

In a patient with severe factor XII deficiency with a baseline prolonged PTT, what is the best method to monitor their ACT or heparin levels when on c...

Ref: EINSTEIN-CHOICE and AMPLIFY-EXT Would you approach this differently in patients with inherited thrombophilias?

For example, a patient on cytoreductive therapy and aspirin BID, but suffers an arterial event, or a patient who is already on therapeutic anticoagula...

In a patient with a medical or personal indication to induce oligomenorrhea/amenorrhea, how would you manage OCP therapy if a patient develops a VTE d...

If there are a low-risk patients who can be monitored, how would you do so? If unprovoked, would you consider stopping anticoagulation?

Is there a preferred strategy of transfusional support versus reduced-dose anticoagulation during the duration of thrombocytopenia?

Especially in a patient without hemophilia or thrombosis history?


Papers discussed in this category


Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis, 2016-04

Blood, 2018 Jul 12

Ann. Intern. Med., 2019 Oct 15

Blood Transfus, 2018 Oct 24

J Thromb Haemost, 2018 May 08

AJR Am J Roentgenol,

J Vasc Interv Radiol, 2020 Sep 09

Blood, 2015 Dec 22

Contraception, 2016 May 03

BMJ, 2008 May 20

Circulation,

Blood Cancer J, 2018 Feb 09

Blood, 2017 May 08

Blood, 2013-12-05

Blood Adv,

Blood,

Lancet (London, England), 2010-07-03

J Intensive Care, 2014 Feb 20

PLoS One, 2021 Apr 08

The New England journal of medicine, 2016-11-10

The New England journal of medicine, 2018-05-31

The New England journal of medicine, 2018-06-14

Lancet (London, England), 2019-05-04

Lung cancer (Amsterdam, Netherlands), 2012-12

N Engl J Med,

Blood,

Cancers (Basel), 2019 Dec 25

N Engl J Med, 2021 Apr 14

Semin Hematol,

Blood, 2016-07-14

Blood, 2016 Sep 26

J Thromb Thrombolysis,

Circulation, 2012-09-25

BMJ, 2021 Jun 09

J Am Heart Assoc, 2020 Nov 23

Am J Hematol,

Blood advances, 2018-11-27

Blood advances, 2018-11-27

Blood Adv, 2017 Jun 22