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» This Changed My Practice » Venous thromboembolism

Venous thromboembolism

Thromboprophylaxis in ambulatory cancer patients

Thromboprophylaxis in ambulatory cancer patients

By Drs. Domnick Manhas and Tony Wan on August 23, 2023

It is estimated that 15% of all cancer patients will develop VTE, resulting in significant morbidity and mortality. The cost of cancer-associated thrombosis is substantial to the healthcare system. Currently, routine thromboprophylaxis is not recommended given the fear of increased risk of bleeding, modest absolute risk reduction in VTE, and inconvenience. However, a selected group of cancer patients with very high VTE risk will benefit from thromboprophylaxis.

COVID-19

Pharmacologic thromboprophylaxis in hospitalized patients with COVID-19

By Drs. Alejandro Dau, Agnes Lee, and Tony Wan on February 22, 2022

COVID-19 is associated with an increased risk of venous, arterial, and microvascular thrombosis. Early reports documented high rates of venous thromboembolism (VTE) in hospitalized patients with COVID-19, with pooled incidences of 20-30%, despite standard-dose thromboprophylaxis. Multiple randomized control trials (RCTs) have sought to determine the safety and efficacy of therapeutic anticoagulation in both critically ill and non-critically ill hospitalized patients with COVID-19.

PAUSE Trial & Thrombosis Canada Guidelines: practice tip

PAUSE Trial & Thrombosis Canada Guidelines: practice tip

By Drs. Elina Liu, Erin Morley, and Anna Rahmani on November 15, 2021

Each year, 1 in 6 patients with atrial fibrillation, or an estimated 6 million patients worldwide, will require perioperative anticoagulant management. An increasing number of atrial fibrillation patients are using direct oral anticoagulants (DOACs) in place of warfarin for stroke prevention. However, there has been uncertainty regarding perioperative management of DOACs, with significant variability noted in clinical practice. This can lead to potential harm with an increased risk of thrombosis if a DOAC is held for too long versus increased risk of post-operative bleeding if interruption intervals are too short.

occult-cancer

Screening for occult cancer in unprovoked venous thromboembolism (VTE)

By Drs. Erica Tsang and Iain Mackie on February 17, 2016

An unprovoked venous thromboembolism (VTE), either through a deep venous thrombosis or pulmonary embolism, may be the earliest sign of malignancy. In patients presenting with unprovoked VTE, a limited occult malignancy screening strategy is sufficient, compared to routinely adding CT imaging of the abdomen and pelvis.

Rivaroxaban for treatment of symptomatic pulmonary embolism: exploring new territories

Rivaroxaban for treatment of symptomatic pulmonary embolism: exploring new territories

By Drs. Jason Hart and Neda Amiri on November 20, 2012

In April 2012, NEJM published The EINSTEIN-PE study, which looked at the use of oral Rivaroxaban for the treatment of symptomatic pulmonary embolism in 4833 patients.


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