Posts Tagged ‘Deep vein thrombosis’
Stephan Moll, MD writes…
The large clinical trial comparing Xarelto (Rivaroxaban) with warfarin in the treatment of patients with newly diagnosed pulmonary embolism (PE) was published in the New England Journal of Medicine March 26th, 2012, showing that Xarelto was (a) as effective as warfarin in preventing new clots, (b) caused the same amount of overall clinically relevant bleeding, and (c) caused less major bleeding. Read the rest of this entry »
Xarelto (Rivaroxaban) was approved in Europe today (Dec 19th, 2011) for patients with acute DVT. This is good news on the path to have a blood thinner for patients with DVT available that is easier to deal with than Warfarin. Read the rest of this entry »
CT scans and MRI scans are often done in medicine, for a variety of reasons. Every so often such a scan will detect a blood clot in a patient who has no symptoms from the clot. This is referred to as an “incidental VTE” (VTE = venous thromboembolism, i.e. clot in a vein) or “asymptomatic VTE”. Such a clot may be a DVT in the pelvis or leg, in the major abdominal vein (vena cava), or in one of the intestinal veins (portal vein, splenic vein, mesenteric vein, or renal vein). When such an incidental, asymptomatic VTE is discovered, the question arises whether the patient should be treated with “blood thinners” or not. Read the rest of this entry »
Stephan Moll, MD writes…
What Kind of Clot did You Have?
If you have had a blood clot in your legs or your lung (pulmonary embolism=PE), you will wonder how long you should stay on a “blood thinner”. The decision depends on a number of factors which will be discussed below. Read the rest of this entry »
It is known that the risk for blood clots in the leg (DVT) and lung (PE) is partly inherited. Some genes that increase the risk for DVT and PE are known (e.g. factor V Leiden, the factor II 20210 mutation, protein, protein C, S and antithrombin mutations). However, it is suspected that many other and, as yet, unidentified genes also increase the risk for DVT and PE. One of the ways to discover such clotting genes is by studying families.
A study is presently ongoing at the Mayo Clinic in Rochester, MN, that is investigating what genes put people at risk for clots (DVT and PE). Read the rest of this entry »
Many people think of blood clots as a problem occurring in elderly people, but not in young and apparently healthy individuals. While it is true that clots occur more commonly in the elderly and in non-athletic overweight individuals, they can, nevertheless, happen in young, normal weight, and athletic people. Read the rest of this entry »
Testosterone Replacement Therapy
Replacement therapy with low doses of testosterone does not adversely affect blood coagulation status [ref 1] and does not appear to increase the risk of venous or arterial blood clots. Thrombosis is not listed as a potential side effect in a commly used drug compendium (Micromedex). Furthermore, the 2006 “Clinical Practice Guideline” from the Endocrine Society also does not list blood clots as a side effect of testosterone replacement therapy, or a previous history of blood clots as a reason not to give testosterone replacement therapy [ref 2]. However, the Androgel® package insert (prescribing information) lists “blood clots in the legs” as a potential side effect Read the rest of this entry »
What is HHT?
HHT (Hereditary Hemorrhagic Teleangiectasia) is an inherited disorder in which small blood vessels develop abnormally [ref 1]. It is also called Osler-Weber-Rendu syndrome. It is estimated that 30,000 to 60,000 people (1 out every 5,000 to 10,000) in the United States have it. Individuals with HHT develop small abnormal blood vessels (teleangiectasias) under the skin (usually in the fingers and hands) and in the lining of the nose and mouth. Read the rest of this entry »
If you or somebody you know has been diagnosed in the last 14 days with a new DVT of the leg (thigh or pelvic veins), I would encourage you to consider participation in the ATTRACT trial – a solid, clinically useful study (NIH funded) that investigates how to minimize the long-term complications after a blood clot – chronic leg pain and swelling (called the post-thrombotic syndrome).
The study investigates Read the rest of this entry »
Some people have a “hole in the heart”, called a “patent foramen ovale” (PFO). This is a connection between the right and the left chamber (atrium) of the heart. We are all born with it – the unborn needs this connection for proper blood circulation. In most people the hole closes in the first few weeks after birth. However, in up to 25 % of people it stays open, equally often in men and women. A PFO usually does not cause symptoms. However, when a person has an acute DVT (deep vein thrombosis) and a clot breaks off and travels with the blood stream, it may cause problems.
DVT and PE in the person without PFO
In the person who does not have a PFO, a clot that breaks off from a DVT travels with the blood stream through the main vein in the abdomen to the chambers of the right side of the heart (color blue in figure 1 and 2). From there, it travels into the lung vessels, where it gets lodged, causing a pulmonary embolism (figure 1).