Thrombus - 2005


Post-thrombotic syndrome
Robert Weinkove and Savita Rangarajan
pp 1-3
Post-thrombotic syndrome (PTS) is a common, debilitating and potentially preventable long-term complication of deep vein thrombosis (DVT). It is characterised by chronic pain, oedema, skin changes and ulceration of the affected limb. PTS occurs in 30% of patients following DVT, and is severe in 10%. The incidence of PTS can be reduced by ensuring an adequate duration and intensity of anticoagulation following DVT and pulmonary embolism (PE), preventing future thrombosis with appropriate thromboprophylaxis, and by daily use of elastic compression stockings.
Comment: Aortic tissue valves: aspirin or warfarin?
Peter Rose
pp 2-2
Following the first mechanical heart valve replacements more than 40 years ago, unacceptably high rates of arterial thromboembolic complications were soon reported. This led to the routine use of anticoagulant prophylaxis with inhibitors of vitamin K-dependent clotting for long-term prophylaxis in patients receiving mechanical heart valves. For many patients, particularly the elderly and those for whom the risks associated with anticoagulant therapy are too high, bioprosthetic valves represent an alternative choice. Long-term thrombotic risks with tissue valves are low, however, early thromboembolic complications in the first three months postoperatively have been reported, particularly in the mitral valve position.
Pathology, presentation and treatment of Behçet’s disease
Tony Todd and Katherine Lowndes
pp 4-7
Behçet’s disease is named after the Turkish dermatologist who described it in three patients with oral and genital ulceration and hypopyon uveitis in 1937. Three years later, he reported four similar cases and named the combination of symptoms the ‘triple symptom complex’. In retrospect, however, it is possible to identify descriptions of the condition in earlier medical literature, perhaps even as far back as the 4th century BC when Hippocrates wrote in his third book of epidemiology of genital ulceration associated with painful, sight-destroying ‘ophthalmies’.
Clinicians’ use of the VQ scan for diagnosis of pulmonary embolism
Paul Beckett and Sutapa Biswas
pp 8-9
Pulmonary embolism (PE) is a common problem that is often misdiagnosed. The true incidence is thought to be approximately 1% of all hospital admissions. PE is not suspected clinically in up to 70% of patients in whom it is subsequently found to be a major cause of death. Similarly, autopsy studies show no evidence of PE in up to 60% of patients recently diagnosed with it. The problem of overdiagnosis and underdiagnosis is in part due to overreliance on the ventilation-perfusion scan (VQ scan) as the primary diagnostic modality.
What does the future hold for anticoagulant nurses?
Caroline Baglin
pp 10-11
All professionals should examine their role on a regular basis. However, the future of anticoagulant nurses has been highlighted by several recent developments. Many of these nurses fear redundancy. Instead of being defensive about their role, they should use this debate as a time to reflect on their work and develop strategies for the future.

Thrombus was previously supported by Bayer from 2014 to 2016, by Boehringer Ingelheim from 2009 to 2013, by sanofi-aventis from 2007 to 2008 and by Leo Pharma from 1998 to 2006.

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ISSN 1369-8117 (Print)  ISSN 2045-7855 (Online)

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