Thrombosis   

Questions discussed in this category



Estimating blood loss from hemoptysis is not always reliable. The bleeding may be due to the PE itself. Is anticoagulation with any degree of hemoptys...

In the setting of requiring anticoagulation for atrial fibrillation and bioprosthetic valve, but also having severe vitamin K deficiency, would you st...

Is it different than early mobility that we always encourage?

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...

I.e. platelet count <30. Would your management change if HIT were only suspected rather than confirmed?  

What is the work up and what is the duration of anticoagulation if used?

Specifically, asymptomatic subsegmental PE diagnosed within a month from planned bilateral mastectomy for breast cancer. 

Significant history of autoimmune diseases and DVT in family, recent PE/DVT for a month

Is patch or gel HRT with ASA prophylaxis a reasonable option after counseling? Or do you add a prophylactic DOAC? 

Would you consider low dose indefinite anticoagulation in any scenario? Any difference in approach between hematological malignancy and solid tum...

If work-up is sent and the patient is found to have a persistently positive antiphospholipid antibody, particularly lupus anticoagulant, would you con...

The patient has no personal history of VTE, but has positive family history of VTE.  Any prophylactic anticoagulation options? How would manage...

I.e., what constitutes well-controlled cancer, IBD, nephrotic syndrome, etc. What other diseases do you put in this category (obesity, autoimmune dise...

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

Should we stop checking factor VIII levels as part of thrombosis workup?

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?

For example, for outpatients or resource-limited settings with a moderate probability 4-T score (but low clinical suspicion), would you ever consider ...

e.g. in the setting of using prophylactic heparin in the past but now requiring therapeutic anticoagulation

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

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...

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

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

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

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

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

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

Would you offer this routinely or only if specific complications arise, such as distal emboli?

Would it make a difference if the VTE diagnosis occurs during bevacizumab therapy or whether it preceded the cancer diagnosis?


Papers discussed in this category


Acta Paediatr., 2020 Mar 23

Blood Transfus, 2018 Oct 24

J Thromb Haemost, 2018 May 08

J Vasc Interv Radiol, 2020 Sep 09

Blood, 2013-12-05

Blood Adv,

Blood,

Thrombosis, 2013

Thrombosis journal, 2023 Oct 26

PLoS One, 2021 Apr 08

N Engl J Med, 2021 Apr 14

J Natl Cancer Inst, 2011 Jul 09

Br J Clin Pharmacol, 2020 Jun 02

Semin Hematol,

Expert Rev Hematol, 2019 Jul 05

J Thromb Thrombolysis,

Blood advances, 2018-11-27

Blood advances, 2018-11-27

Autoimmun Rev, 2017 Sep 09

Blood Adv, 2017 Jun 22

Circulation, 2022 Nov 06

Circulation, 2022 Nov 06

Lancet,

Post reproductive health, 2022 Dec 27

J Thromb Haemost, 2021 Jul 14

Blood, 2020 Mar 19

Haematologica, 2019 Jan 03

Journal of hospital medicine, 2019-01

The New England journal of medicine, 2019 Feb 18

Phlebology, 2020 Mar 02

VASA. Zeitschrift fur Gefasskrankheiten, 2001 Jul

Journal of vascular surgery, 2000 Nov

Blood, 2014 Oct 15

Circulation. Cardiovascular interventions, 2015-10

Research and practice in thrombosis and haemostasis, 2018 Oct 19

Thrombosis and haemostasis, 2019 Oct 28

Journal of thrombosis and haemostasis : JTH, 2021 Apr 01

Journal of medical case reports, 2014 Mar 04

Circulation, 2011-12-20

American journal of kidney diseases : the official journal of the National Kidney Foundation, 2013-01

American journal of nephrology, 2013

Journal of the American Heart Association, 2021 Jun 26

Autoimmunity reviews, 2017 Feb 13

Thrombosis research, 2023 Feb 10

Lupus, 2017 Mar 29

Respirology (Carlton, Vic.), 2018 Jul 16

Journal of thrombosis and haemostasis : JTH, 2019 Sep 13

The Journal of clinical endocrinology and metabolism, 2024 Jan 18