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VEIN CLOT CLEARED in 30 MIN UTES      3 pages

Latest Care for Thrombosis

DVT remains a common problem, asymptomatic in at least 50% of patients. It is poorly understood with a large proportion of cases being classified as "idiopathic" cause not known.

These "causeless" clots are responsible for the highest recurrence rate 20-30% within two years.

 

Schedule online. It's easy, fast and secure.

This is an example of a FLOATING Femoral DVT often arising from Popliteal Vein Compression. These are Silent and Deadly

Major DVT with obstruction of the large veins of the thigh or pelvis is associated with Warfarin medication is being substituted with oral anti Xa inhibitors but there has been no functional advantage shown with the dosage currently recommended.

Warfarin shows only a 10% recanalisation of major central thrombus and 40% show extension on treatment. The trials have shown the NOACs the new agents only as equivalent in efficacy to Warfarin, a little safer in regard to bleeding. These agents all are satisfactory at prevention but poor in treatment of DVT especially in regard to life threatening central DVT.
Full dose Unfractionated heparin administered in the Gusto style with weight adjusted dosing is more effective, clot extension 12% or less. Clexane with full weight adjusted dosing shows extension in 4-6%. I have found extended therapy with Clexane the most effective means to manage DVT and it can be administered for months with Duplex assessments to assess progressive results.
The Companies providing NOACs  organised trials purporting to do a comparison with Clexane have all generally only used Clexane for a few days as a bridge to Warfarin treatment. They are Warfarin comparisons.

                  STASIS EFFECTS FROM BLOCKED and INCOMPETENT DEEP VEINS

Because of the poor results with standard therapies more active treatment has been tried in the form of Clot Lysis with agents such as Urokinase, tPA and in the past Streptokinase. Given systemically they can have a dramatic effect on the blood and complications such as intracranial haemorrhage and death are significant.

Efficacy was increased dramatically and risk similarly reduced with Pharmamechanical Thrombolysis managed with Machines and Catheters that allow lacing of the clot with the lytic using a pressure spray and after the device is reconfigured to allow Venturi aspiration of the thrombus. The lytic phase takes 30 mins,it can be repeated; or adjuvant therapies such as balloon angioplasty or Venous stents can be introduced to maintain the new lumen and the flow required to keep it open.

Simple catheter directed lysis would often take days to get a result.

 

 

 

 

Our Hybrid EndoVascular Lab : Theatre/Xray where we carry out these procedures

 

 

HYBRID endovascular.jpg

Latest Care for Thrombosis

DVT remains a common problem, asymptomatic in at least 50% of patients. It is poorly understood with a large proportion of cases being classified as "idiopathic" cause not known.

These "causeless" clots are responsible for the highest recurrence rate 20-30% within two years.

 

Schedule online. It's easy, fast and secure.

This is an example of a FLOATING Femoral DVT often arising from Popliteal Vein Compression. These are Silent and Deadly

Major DVT with obstruction of the large veins of the thigh or pelvis is associated with almost no flow in the clot; if any it is microvascular and takes time to develop, drugs therefore have limited penetration. Warfarin medication has never worked on the clot; it changes clotting factors produced by the liver, it is being substituted with oral anti Xa inhibitors but there has been no functional advantage shown with the dosage currently recommended.

Warfarin is associated with only a 10% recanalisation of major central thrombus and 40% show extension on treatment. The trials have shown the NOACs the new agents only as equivalent in efficacy to Warfarin, a little safer in regard to bleeding. These agents all are satisfactory at prevention but poor in treatment of DVT especially in regard to life threatening central DVT.
Full dose Unfractionated heparin administered in the Gusto style with weight adjusted dosing is more effective, clot extension 12% or less. Clexane with full weight adjusted dosing shows extension in 4-6%. I have found extended therapy with Clexane the most effective means to manage DVT and it can be administered for months with Duplex assessments to assess progressive results.
The Companies providing NOACs  organised trials purporting to do a comparison with Clexane have all generally only used Clexane for a few days as a bridge to Warfarin treatment. They are Warfarin comparisons.

 

                STASIS EFFECTS FROM BLOCKED and INCOMPETENT DEEP VEINS

Because of the poor results with standard therapies more active treatment has been tried in the form of Clot Lysis with agents such as Urokinase, tPA and in the past Streptokinase. Given systemically they can have a dramatic effect on the blood and complications such as intracranial haemorrhage and death are significant.

Efficacy was increased dramatically and risk simultaneously reduced with Pharmamechanical Thrombolysis managed with Machines and Catheters that allow lacing of the clot with the lytic using a pressure spray and after the device is reconfigured to allow Venturi aspiration of the thrombus. The lytic phase takes 30 mins,it can be repeated; or adjuvant therapies such as balloon angioplasty or Venous stents can be introduced to maintain the new lumen and the flow required to keep it open.

Simple catheter directed lysis would often take days to get a result.

 

 

      Our Hybrid EndoVascular Lab : Theatre/Xray where we carry out these procedures

 

 

HYBRID endovascular.jpg
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