A Clearinghouse for Information about Blood Clots (DVT/)PE) and Clotting Disorders (thrombophilia) provided as a public service by the University of North Carolina Blood Research Center

Author: Stephan Moll

  • May-Thurner Syndrome

    Summary Some people have a narrowing of their big left pelvic vein (= left common iliac vein) that can put them at risk for a blood clot (deep vein thrombosis = DVT) in that area and in the left leg. The narrowing is due to pressure onto the vein by the overlying big pelvic artery…

  • Pradaxa – Management of Major Bleeding

    Major and life-threatening bleeding is expected to occur in some patients treated with Pradaxa® (=Dabigatran). The question will then urgently arise how to best treat such catastrophic bleeding.  As there have been no data published on this topic in the peer-reviewed medical literature, we don’t know how to best manage a patient with major and…

  • Safe Pain Medications on Warfarin

    Certain pain medications increase the risk of bleeding in patients on warfarin (coumadin®, Jantoven).  Two mechanism can be at play: (1) non-steroidal pain medications (NSAIDs = non-steroidal anti-inflammatory drugs) may lead to gastritis which can lead to bleeding into the stomach, made worse by being on “blood thinners”, and (2) pain medications taken on a…

  • Heavy Menstrual Bleeds on Blood Thinners – What to Do?

    Evaluation Warfarin (coumadin®, Janotven®) and other blood thinners often increase the amount of bleeding during menses and sometimes the number of days that a woman bleeds.  However, this does not happen in everyone – in some women there is no change in the bleeding pattern.  In general, the more vaginal bleeding a woman has, the…

  • Long Distance Travel and Blood Clots

    Background and Summary Long distance travel, either by plane, car, bus or train, is a slight risk factor for DVT (deep vein thrombosis) and PE (pulmonary embolism). The risk is low. However, there are some people who are at higher risk. In these people compression stockings and/or an injection of a low-dose “blood thinner” (low…

  • INRs that Fluctuate

    Background and summary Quite a few patients on warfarin have unstable, i.e. significantly fluctuating INRs, making warfarin therapy quite cumbersome.  The cause of such fluctuations is often not clear.  However, the following causes should be considered. Solutions how to deal with fluctuating INRs are also listed below.

  • Thrombophilia Testing – Who Should be Tested?

    Background and Consensus Guidelines No general consensus exists as to which patients with blood clots and which family members should be tested for thrombophilias.  At least five guidelines or consensus statements exist (ref 1-5).  They vary markedly in their recommendations as to who should be tested and who not,

  • Unexplained Arterial Clots – Causes, Thrombophilia Testing

    Background, anatomy Arteries are the blood vessels that lead blood away from the heart into the periphery, i.e. to the extremities, the brain, the abdominal and pelvic organs. They deliver oxygen to organs and muscles. Veins lead the blood back to the heart, from where it flows into the lung to take up fresh oxygen.…