Neurosurgical patients are at increased risk for thrombosis and for bleeding. The risk for thrombosis is elevated in cancer patients as well as patients who have had an intracranial bleed. The risk for bleeding is also elevated in both cases. Neurosurgery in itself has been found to be a risk factor for both deep vein…
The most obvious side effect of anticoagulation is bleeding. Anticoagulation can also cause unwanted thrombosis in the form of heparin induced thrombocytopenia (HIT). However there are also other, more rare side effects of anticoagulation. One such side effect is skin necrosis. This can be in the form of Warfarin skin necrosis or heparin skin necrosis….
Paget Schroetter Syndrome is a type of thoracic outlet syndrome. It is neither positional nor secondary to indwelling catheters. Paget Schroetter is deep vein thrombosis related to effort. Therefore, Paget Schroetter syndrome is also called ‘effort related thrombosis of the subclavian vein’. Despite the relative rarity of Paget Schroetter syndrome, it has drawn quite a…
A deep vein thrombosis that is isolated to the calf veins is considered to be different than a deep vein thrombosis that is located in the popliteal vein or more proximal at the level of the thigh or pelvis. Calf vein thrombi are often referred to as “distal DVT” as to differ them from proximal…
Oral Xa inhibitors are becoming the most prescribed anticoagulants for atrial fibrillation and venous thromboembolism. They are easy to take, have few interactions and are safer than Warfarin in most cases. Also, there are antidotes which may or may not have clinically meaningful benefit. Still, anti Xa inhibitors are not appropriate for all indications. The…
A blood clot in the deep veins of the arms, shoulders or neck is known as an upper extremity deep vein thrombosis (upper extremity DVT). These clots almost never spontaneous. There is almost always an underlying cause. Depending on the cause, outcomes are usually favorable, with proper treatment. Epidemiology and Natural History Upper extremity DVT…
A catheter can result in superficial vein thrombosis and in deep vein thrombosis. As we are using catheters more often, we see catheter associated thrombosis more. IV lines and peripherally inserted central catheters (PICC) poses a risk for these clots to form. Modern series report a rate of 2-5% for upper extremity DVT associated with catheters….
Fondaparinux is a direct Xa inhibitor. It is a form of anticoagulation that can be viewed as an alternative to heparin and low molecular weight heparin. Fondaparinux has unique advantages and disadvantages that will be discussed in this article. Background Fonadparinux is a subcutaneously administered factor Xa inhibitor. It is a synthetic analog of the…
Estrogen containing oral contraceptives have been prescribed since the early 1960’s, after being developed in the 1950’s. These pills were immediately embraced and perceived as herralding a new feminine revolution. As oral contraceptives (OCP) are commonly used worldwide, this question has some important potential implications for many women. Perhaps one of the most dreaded complications…
Jugular vein thrombosis is not common. It may occur in the internal or in the external jugular vein. Usually, a clot in the internal jugular vein is either the result of a procedure, or extension of clots in the arm veins. Prevalence The prevalence of upper extremity DVT is about 10% of all deep vein…
