Although the mainstay of treatment for both prevention and treatment of venous thromboembolism (VTE) is anticoagulation, there are several clinical situations where adjuvant therapies, such as thrombolysis or placement of an inferior vena cava (IVC) filter, may be considered. In addition, the increased use of life-saving devices such as ventricular assist devices (VADs) and extracorporeal membrane oxygenation (ECMO) pose unique challenges regarding the use of anticoagulants to prevent thrombotic complications.
Dr. Leslie Raffini will review the indications for VADs and ECMO and highlight the physiologic and hemostatic alterations created by these devices. She will discuss current anticoagulation and antiplatelet strategies to prevent thrombosis, both in children and adults. Dr. Raffini will mention potential novel therapeutics that may be useful in the future to help reduce complications.
Dr. Suresh Vedantham will discuss the use of mechanical and pharmacologic agents to disrupt thrombus and restore venous flow to prevent or treat post-thrombotic syndrome (PTS) in patients with VTE. He will discuss the results from the recently completed ATTRACT Study: a large, randomized clinical trial of pharmacomechanical catheter-directed thrombolysis to prevent PTS in patients with acute proximal deep vein thrombosis.
Dr. William Geerts will review the epidemiology regarding the use of IVC filters. He will discuss potential indications for IVC filters and examine the evidence to support their use. Dr. Geerts will review potential complications of IVC filters and make recommendations on how to manage patients who have filters placed.