Various medical conditions carry an elevated risk for thromboembolism. Examples of such conditions include deep venous thrombosis that may embolize to a pulmonary embolus or atrial fibrillation that may cause embolic stroke. Knowing the risk that each condition carries is important for clinicians because it will guide decisions regarding the need for anticoagulation, length of…
The combination of anticoagulation and surgery poses a set of unique challenges. What is the risk of performing surgery if anticoagulation is not held? What is the risk of thrombosis (e.g. arterial embolism, deep vein thrombosis or pulmonary embolism) if anticoagulation is stopped before surgery? When should anticoagulation be started after surgery? How should anticoagulation…
Carotid artery occlusion may be found incidentally or when looking for a cause for acute stroke. It can be an endpoint of carotid artery stenosis or a result of a large embolus. In both cases occlusion results from thrombosis. Diagnosis The diagnosis of carotid artery occlusion is made by vascular imaging. Duplex ultrasound can show…
Carotid artery stenosis treatment can be medical, endovascular or surgical. It is a matter of debate. On the one hand, not interfering with the natural history of a disease may sometimes result in a stroke. This is especially true in symptomatic patients. On the other hand treatment itself may result in unwanted consequences. Patients may…
Patients with peripheral artery disease are sick. They often do not only have disease in their legs, but also in other vascular beds such as the brain and the heart. Therefore, some would suggest prescribing antiplatelet agents such as aspirin or clopidogrel to these patients for primary prevention of cardiovascular events. Some actually claim that…
Starting Warfarin treatment is a common scenario in clinical medicine. Both hospital based physicians and primary physicians need to know how to start Warfarin treatment for their patients. Although oral Xa inhibitors and direct thrombin inhibitors show great promise to substitute Warfarin, it is still a widely used, time proven, medication. This article will discuss…
Treating a patient that has carotid artery stenosis can potentially cause damage. So intervention needs to balance risk of stroke with medical therapy. It is well known that the benefit of treating carotid artery stenosis is higher in symptomatic patients than in asymptomatic patients. If the patient is asymptomatic and has never had a stroke…
Upper extremity embolism will result in upper extremity ischemia. The onset is usually acute. The extremity or part of it will be painful. There will be change of color. The color will be either bluish or pale, white. The limb will be cold. In more advanced cases, there will be limited sensation and motor function….
Patients with cancer are at an increased risk for venous thromboembolism. The classic ‘Trousseau syndrome’ in which migratory superficial vein thrombosis heralds pancreatic cancer is just an example. Often venous clots in cancer patients present as deep vein thrombosis and pulmonary embolism. The Many Causes for Venous Clots in Cancer Patients Venous clots in cancer…
Varicose veins have troubled mankind for thousands of years. Varicose veins are mentioned as early as 1550 B.C. in the Ebers papyrus, where it was recommended not to treat them. Varicose veins were also mentioned in ancient Greece. The role of varicose veins and venous hypertension in creating venous ulcers was recognized as early as…
