"Complicated situations in the treatment of venous thrombosis: how to achieve a better result?", Moscow, 15.11.2017.
- Author: Semenov Artem Yuryevich
- Category: News
- Views: 467
15 November 2017 in the hotel "Raikin Plaza" the next, the third scientific and practical event from the series "School of thrombosis" on "Complex situations in the treatment of acute venous thrombosis: how to achieve the best result?" Was held.
The session was opened by Kirill Viktorovich Lobastov, Ph.D., associate professor, surgeon-phlebologist (Moscow), presenting several reports.
Reported by Ph.D. Lobastov K.V. (Moscow)
In his first lecture, he turned to the nuances of anticoagulant therapy in so-called "complex" patients (old age, the presence of kidney failure, the presence of recurrent thrombosis). These patients are characterized by increased risks of both thrombosis and bleeding, and therefore the choice of therapy for them is always a challenge. According to recent research, the optimal for this group of patients will be preparations from the group of new oral anticoagulants (PLAK), such as Apixaban and Rivaroxaban. Both have proved to be highly effective and safe in comparison with the classical therapy regimen (low molecular weight heparins with the transition to vitamin K antagonists).
In the second part of the report, Kirill presented a report on the topic: "What to choose: an anticoagulant, a disaggregant or all at once." A large proportion of patients with thromboembolic complications are patients with concomitant cardiovascular diseases. In modern medical practice, for the prevention of thrombosis, ischemic events (strokes, infarcts), physicians often use two or more drugs. Most often this is a combination of 1) anticoagulant (PLAA, heparins) and disaggregant (acetylsalicylic acid, clopidogrel), 2) a combination of two disaggregants, 3) anticoagulant and two disaggregants. In this context, the results of the COMPASS study are very interesting, showing the clear advantage of using mini-doses of rivaroxaban (2,5 mg) with aspirin (100 mg). It consisted in a marked reduction in cardiovascular complications and overall mortality, with an improved safety profile.
In his third lecture, Dr. Lobastov disclosed the topic of hereditary thrombophilia.
Reports by Dr. med. Somonova O.V. (Moscow)
Oksana Vasilievna Somonova (Moscow), leading research associate of KDL "NMIc oncology named after. N.N. Blokhina, MD, spoke about the features of the approach to the prevention and treatment of thrombosis in cancer patients.
Evgeny Arkadevich Ilyukhin (St. Petersburg), member of the Executive Board of the Russian Phlebology Association, the European Venous Forum (EVF) presented a very interesting message on the topic "How to reconcile pregnancy, D-dimer and anticoagulant?"
Reported by Ph.D. Ilyukhin EA (St. Petersburg)
Thromboembolic complications during pregnancy and in the near postpartum period are a serious problem in medical practice and doctors try to closely monitor the condition of a woman at this time. The D-dimer is a fragment of the fibrin molecule (thrombus base) formed during its decomposition. A wide clinical application in the diagnosis of thrombosis in this indicator was found in 1990 years. But in recent years, around the D-dimer appeared a large number of myths and misconceptions, which often affect the tactics of specialists is not always beneficial to patients.
Evgeny Arkadevich, on the basis of an analysis of domestic and foreign research, presented an expert point of view on this problem. D-dimer always rises in pregnancy, but as such, its norms (for the period of pregnancy) do not exist and its high values do not speak about the risk of thromboembolic complications. The use of heparins in this situation is not justified and is a senseless and potentially dangerous practice. Anamnesis data, including obstetric, somatic and family history of a woman, are leading in assessing the risk of obstetric complications.
Ilya Veniaminovich Schastlivtsev (Moscow), Ph.D., member of the European Venous Forum, European Society for Vascular Surgery, Russian Phlebology Association presented two lectures.
Reported by Ph.D. Schastlivtsev I.V. (Moscow)
In the first report he told about the nuances of diagnosis and treatment of heparin-induced thrombocytopenia. This pathology is extremely dangerous, but with timely diagnosis and treatment, it is possible to avoid fatal complications. In the second message Ilya Veniaminovich revealed the topic "Thrombosis of the veins of the upper limb, the magnitude of the problem and approaches to treatment."
Viktor Evgenievich Barinov (Moscow), Doctor of Medicine, Professor, Head of the Department of Vascular and Endocrine Surgery Clinical Hospital No.1 (Volyn) of the Presidential Administration of the Russian Federation presented a lecture on the topic: "Is a" bridge "necessary?
Reported by Professor, MD. Barinov V.E. (Moscow)
The tactics of perioperative management of patients receiving long-term aticoagulant therapy. " These patients are complicated due to the increased risks of both thrombosis and bleeding. Viktor Evgenevich disclosed the methodology for assessing and making informed decisions for the effective and safe management of these patients during the perioperative period.
The event ended with a supper-buffet in the restaurant of the hotel "Raikin Plaza".