Introduction Acute central nervous system (CNS) diseases are notable for two critical features. The first, and perhaps most obvious, is that these are diseases that are life threatening and likely to cause major permanent neurologic disability. In short, the consequences…
The coumarin-type oral anticoagulants have been in use for more than 70 years and are well-established weapons in the armamentarium against thrombotic disease. Their discovery evolved from investigations into a hemorrhagic disease of cattle occurring early in the 20th century…
Introduction The liver plays a pivotal role in thrombosis and hemostasis because it synthesizes many hemostatic proteins. All procoagulant plasma proteins; the anticoagulant plasma proteins except for tissue factor pathway inhibitor; the fibrinolytic plasma proteins plasminogen, α 2 -antiplasmin, thrombin-activatable…
Millions of people in the United States are on antithrombotic therapy—either antiplatelet therapy or anticoagulants—for treatment and prevention of venous and arterial thromboembolism. During a given year, as many as 10% of these patients will need an invasive procedure. How…
By observing and studying the effects of surgery and trauma on hemostasis—including physiologic as well as hypocoagulable and hypercoagulable situations—our understanding of the interrelationship between hemostasis and surgery has been advanced. The following six topics will be addressed in this…
Introduction Pregnancy is associated with an increased risk of venous thromboembolism (VTE). This increased risk is mediated by physiologic changes that occur during and immediately following pregnancy and that may have enhanced survival during evolution by decreasing hemorrhage at parturition.…
Introduction Successful management of bleeding in pregnancy requires an understanding of the various scenarios in pregnancy in which bleeding can arise. In this chapter the discussion is focused on pregnancy-related bleeding, including bleeding due to obstetric, surgical, and systemic causes.…
Hormones are administered in various forms for contraception, postmenopausal symptom management, treatment of hormone-responsive cancers, breast cancer risk reduction, and therapy in transgender individuals. This chapter will focus on the association of estrogen and/or progestin therapy with thromboembolic disease. The…
Vena Cava Filters Introduction Venous thromboembolism (VTE), a disease entity that includes deep venous thrombosis (DVT) and pulmonary embolism (PE), is a common cause of morbidity and mortality in the United States. Administrative data indicate that 467,000 patients in this…
Overview and Technical Considerations The clinical procedures collectively referred to as apheresis involve the separation of a solute or cellular component of the blood for removal or for treatment and reinfusion. Apheresis was first introduced as a novel therapeutic modality…