Clinical Conversations

August 2nd, 2019

Podcast 227: Chronic kidney disease and anticoagulants

Chronic kidney disease, being a “prothrombic state,” would seem to warrant use of anticoagulants, yet they aren’t often used — why? The problem seems to be a lack of data with which to evaluate their effectiveness and possible harms. Big drug trials seem to avoid recruiting these patients, especially those in the later stages of […]

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March 9th, 2018

Podcast 217: Aspirin and rivaroxaban “comparably effective and safe” for prophylaxis after arthroplasty

The EPCAT II trial examined whether aspirin and rivaroxaban were clinically equivalent in the extended prophylaxis of venous thromboembolism after hip or knee replacement. They proved “comparably effective and safe,” according to our guest, Dr. David Anderson, the study’s first author. An editorial in the New England Journal of Medicine, where the study appeared in […]

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August 14th, 2010

Podcast 97: What happens when vena cava filters break?

Vena cava filters, often meant to be permanent, can actually lose a strut or two. And it’s not as rare an occurrence as you might think. Our conversationalist found it happens about 15% of the time with a certain brand of filter. The FDA has announced that it’s starting its own studies of the problem. […]

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June 19th, 2009

Podcast 46: Does Genetic Testing for Clotting Mutations Matter? An interview with Jodi Segal of Johns Hopkins

You’d think that a widely-ordered test would play a part in management and outcome, but two clotting mutations seem exceptions to that rule. Although often requested, the FDA-approved tests for Factor V Leiden and G20210A mutations don’t seem to figure greatly in case management of venous thromboembolism, at least according to the published literature. Dr. […]

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