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

Category: Uncategorized

  • Progestin-only Contraceptives and Thrombosis

    Background It is well known that combination contraceptives (containing estrogens AND progestins) increase the risk for venous thromboembolism (VTE). Relatively few data, however, have been published on progestin-only contraceptives, so that until recently it was not clear whether they increase the risk for venous thromboembolism (VTE) or not.

  • Family Member Testing For Thrombophilia

    Background If a thrombophilia (clotting disorder) has been identified in a patient with blood clots (venous thromboembolism = VTE), the question arises whether other family members should be tested for the same thrombophilia. My Clinical Approach My approach in clinical practice to thrombophilia testing in family members is summarized in table 1: Family Member Testing. If the patient

  • Dental Work on Warfarin

    A number of dental procedures can be done safely withouthaving to discontinue warfarin. A clinically helpful table is can be found here: Dental procedures and Warfarin (from ref 1).

  • Unexplained Arterial Thrombosis – Causes, Thrombophilia Testing

    Causes The 2 main causes of arterial thromboembolism are certainly arteriosclerosis and atrial fibriallation. Only uncommonly do arterial clots occur in persons less than 40 or 50 years of age who do not have arteriosclerosis or atrial fibrillation.  Under these circumstances, a number of uncommon conditions, including  thrombophilias, should be considered and investigated (see table 1: Causes and work-up).

  • INRs that Fluctuate – Solutions

    Background and summary The cause  of fluctuating INRs in patients on warfarin is often not clear.  The following causes should be considered. Solutions how to deal with fluctuating INRs are listed further below.

  • Arm and Leg Veins – Anatomy + Terminology

    Confusion as to which veins of arms and legs are superficial and which are deep can lead to misclassification superficial thrombophlebitis and DVT and, thus, to incorrect treatment decisions. A. Arm Veins Graph of  Arm vein terminology Basilic and cephalic veins are superficial veins; Brachial veins

  • Xarelto® – Good News

    Summary Good news. A major study published in December 2010 in the  New England Journal of Medicine (NEJM) shows that the new oral “blood thinner” Xarelto® (=Rivaroxaban) is (a) as safe and effective as warfarin in patients with acute DVT, and (b) is quite effective in preventing recurrent venous thromboembolism if taken longer-term, with an…

  • May-Thurner Syndrome

    Summary A congenital stenosis of the left main pelvic vein (= left common iliac vein) by pressure from the overlying right common iliac artery (image 1) is referred to as May Thurner syndrome. While this anatomic variant is a risk factor for DVT, in many people is causes no symptoms and is irrelevant.