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Incidentally Discovered DVT, PE or Other Clots
General comments CT or MRI scans will occasionally detect an incidental iliofemoral DVT, PE or intra-abdominal thrombosis (IVC, portal, splenic, mesenteric or renal vein). This is particularly common in cancer patients undergoing staging CT scans. When such an incidental, asymptomatic venous thromboembolism (VTE) is discovered, the question arises whether the patient should be treated with…
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Pradaxa: Interruption for Colonoscopies, Dental Procedures, Surgery, etc.
When to stop the drug – General comments The patient on Pradaxa® (Dabigatran) may need interruption of therapy for dental work, a medical procedure such as colonoscopy, or minor or major surgical procedure. As to when exactly to take the last dose of Pradaxa® before the procedure depends on (a) what type of procedure is…
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DVT and PE: How Long to Treat With Anticoagulants?
Explanation for Patients The complex topic of “Length of Anticoagulant Treatment” for patients with VTE is being addressed in a blog entry written for patients, found on the Clot Connect patient education blog (here). For the Health Care Professional Well respected treatment guidelines exist [ref 1,2].
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Warfarin-Induced Skin Necrosis
How common is it? Warfarin-induced skin necrosis is a rare complication of warfarin (coumadin®, Jantoven®) therapy. It occurs in approximately 1 of 10,000 patients treated with warfarin. What is it? Patients with warfarin-induced skin necrosis develop very painful skin areas, most commonly in the breasts,
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Purple Toe Syndrome
Warfarin can, in rare instances, cause violaceous painful discoloration of the toes and the sides of the feet, referred to as the “purple toe syndrome” 1 – see photograph below. Occasionally, the hands can also be involved and a net-like skin rash on abdomen and legs (= livedo reticularis) can occur. This typically happens within the…
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Low Molecular Weight Heparins – Osteoporosis?
Occasionally, a patient is treated with long-term low molecular weight heparin (LMWH) (enoxaparin = Lovenox®; Dalteparin = Fragmin®; Tinzaparin = Innohep®) . LMWH may be given because the patient (a) tolerated warfarin poorly (widely fluctuating INRs; significant side-effects, such as marked hair loss or fatigue), (b) had a recurrent thrombotic event which occured with a therapeutic INR, or…
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Hair Loss on Warfarin
How common is it? Hair loss is a known side effect of warfarin, but has hardly been studied [ref 1]. Solid data on how frequently it occurs, on its time-course, and on treatments are not available. Mild hair loss appears to be common, severe hair loss uncommon, complete hair loss has not been reported.
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Apixaban (Eliquis®) – Another New Oral Anticoagulant
Good news. Another one of the new oral anticoagulants in development, Apixaban (Eliquis®), has moved forward. On May 20th, 2011, the European Medicines Agency (EMA) approved Eliquis® for DVT prevention after orthopedic surgery (hip and knee replacement) in the 27 countries of the European Community. In the U.S., however, Eliquis® is still some way away from getting FDA approval
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
Clot Connect 