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Stephan Moll, MD writes (last updated: Sept 9th, 2020)… Background: Hospitalized patients with COVID-19 are at increased risk for thrombosis – DVT, PE, and may be pulmonary micro-vascular thrombosis that possibly contributes to respiratory failure; arterial events appear to occur less commonly. Scientific/clinical data on prevalence of thrombosis, best prevention, and optimal therapy are limited.
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In the patient with deep vein thrombosis-DVT who has leg pain and swelling, their leg may feel better with use of compression stockings. Compression stockings may also prevent post-thrombotic syndrome-PTS. Detailed information about compression stockings, written for patients, is available in this post. A handout on compression stockings which you can print to provide patients
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Stephan Moll, MD writes… Good news: The large phase 3 clinical trial comparing 3-12 months treatment of Rivaroxaban (Xarelto) with warfarin in patients with newly diagnosed pulmonary embolism was published on 3-26-2012 in the New England Journal of Medicine [reference 1], showing that Rivaroxaban was (a) noninferior to warfarin in its efficacy, (b) caused the
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Stephan Moll, MD writes… A detailed, practical discussion on INR self-testing for patients is available here, addressing: Reasons to do INR self-testing Which patients are suitable What INR home monitoring devices are available Whether the devices give reliable INR results Whether insurance companies pay for them
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Stephan Moll, MD writes….. When a young person is diagnosed with extensive pelvic DVT or inferior vena cava thrombosis, there may be an underlying and predisposing congenital abnormality of the IVC, such as a congenital absence (agenesis, aplasia) or narrowing (hypoplasia) of the IVC
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Stephan Moll, MD writes… This month the American College of Chest Physicians (ACCP) published its new (2012) guidelines regarding anticoagulation and management of various thrombotic disorders, replacing the 2008 edition. The details of the new guidelines can be found here
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Quick note: New ACCP (American College of Chest Physicians) guidelines on antithrombotic therapy published today: http://www.chestnet.org/accp.
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Stephan Moll, MD writes… Traditionally, INR testing in patients on warfarin has been recommended by anticoagulation providers in the U.S. to be done at least once every 4 weeks. However, a recent study showed that testing every 3 months is sufficient
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Stephan Moll, MD writes… INR testing in patients on warfarin is classically done in a physician’s office or anticoagulation clinic, via (a) i.v. blood draw and central lab testing, or (b) a finger-stick and testing on a POC (point-of-care) device. POC devices give reliable INR results
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Xarelto (Rivaroxaban) was approved in Europe today (Dec 19th, 2011) for patients with acute DVT. This is good news
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
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