J. Bargon, J. Bernarding, R. Rizi, H-W. Spiess, K. Münnemann, M. Roth, and U. Bommerich Institute of Physical and Theoretical Chemistry, University of Bonn, Bonn, NRW, Germany, Institute of Biometry, University of Magdeburg, Magdeburg, Germany, Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, United States, NMR, Max-Planck Institute of Polymers, Mainz, Germany, I...

P a t i e n t s 299 patients > 16 years of age (median age 69 y, 54% women) who presented with clinically suspected PE and a plasma D-dimer level > 500 μg/L. Exclusion criteria were contraindication to CT or anticoagulants (serum creatinine level > 150 μmol/L, allergy to contrast agent, asthma, or pregnancy), treatment with oral anticoagulants on study entry, probable difficulty of follow-up, o...

Stroke prevention in elderly atrial fibrillation patients remains a challenge. There is a high risk of stroke and systemic thromboembolism but also a high risk of bleeding if anticoagulants are prescribed. The elderly have increased chronic kidney disease, coronary artery disease, polypharmacy, and overall frailty. For all these reasons, anticoagulant use is underutilized in the elderly. In thi...

Anticoagulation instability due to a change in intake of vitamin K after dietary modification was observed in 2 patients on long-term oral anticoagulants. One patient developed diffuse bruises treated conservatively with fresh frozen plasma transfusion and the other had a thrombosed aortic prosthesis which required emergency operation. To prevent such complications, dietary modification especia...

Thromboembolic phenomena are common in the elderly population and their consequences can be life threatening. Although anticoagulants are the mainstay of therapy, there are conditions in which their use is contraindicated. Alternative therapeutic options involve the use of more invasive techniques to prevent major thromboembolic incidents. We describe a case in which a modified Greenfield titan...

This article reviews current and future treatment practices concerning oral anticoagulants. In the second decade of the 21st millennium clinicians can finally treat thrombotic disease with long-awaited new oral anticoagulant medications. In addition, improvements have been made in managing warfarin, the traditional but far from obsolete medication. The first part of this review will cover curre...

Anticoagulants have been used for 20 years for the treatment of thrombosis. This practice has been based on the original experiments of Pupini (1932), Murray, Jaques, Perrett, and Best (1937), and Dale and Jaques (1942) which showed that anticoagulants could prevent the formation of experimental thrombi in dogs. There has been, however, no method reported by which it is possible to produce thro...

PURPOSE OF REVIEW New data have been made available in the field of haemostasis and thrombosis. Some long-awaited answers to important questions have been published, and some debates have benefited from an updated perspective. RECENT FINDINGS Two important domains are addressed in this update: massive bleeding (1/1/1 ratios and fibrinogen concentrates) and the management of direct oral antico...

The new oral anticoagulants are rapidly replacing warfarin for several indications. In contrast to warfarin, which lowers the functional levels of all of the vitamin K-dependent clotting factors, the new agents target either factor Xa or thrombin. With targeted inhibition of coagulation, the new oral anticoagulants have pharmacologic and clinical features that distinguish them from warfarin. Fo...

Anticoagulants are effective at preventing and treating thrombosis, but can cause bleeding. For decades, vitamin K antagonists (VKAs) have been the only available oral anticoagulants. The development of non-VKA oral anticoagulants (NOACs), which inhibit either factor Xa or thrombin stoichiometrically, has provided alternatives to VKAs for several indications. The results of recent large-scale r...