Thrombus - 2016

New advances in acute stroke management: the Cambridge experience
Jennifer Mitchell
pp 49-52
Stroke is the second biggest cause of death worldwide and the fourth biggest in the UK. Strokes can be either ischaemic (85%) or haemorrhagic (15%). The mainstay treatment for ischaemic strokes is intravenous thrombolysis treatment with alteplase. Thrombolysis can be given up until four and a half hours from onset of symptoms. It involves a drug that breaks down the clot, restoring blood flow to the affected area of the brain. The earlier it is given the better; however, it is associated with a risk of bleeding. It is not suitable for all patients; for example, if they have had recent surgery or are on an anticoagulant for atrial fibrillation. Of the patients that are given thrombolysis, about one-third will achieve recanalisation of their affected blood vessel.
Comment: Twenty years, over and out
Peter Rose
pp 50-50
As I sign off after 20 years as Editor of Thrombus, many of the current issues and concerns remain remarkably familiar. One on-going topic, addressed in this issue, is the role of thromboprophylaxis for patients undergoing day surgery. There remains a paucity of information to quantify the risk of venous thromboembolism for different surgical procedures, let alone the evidence for benefit of anticoagulant prophylaxis. It, therefore, is helpful to read the real-world experience and outcomes from the Norfolk and Norwich University Hospital.
Clot slot

pp 53-53
The CLOT conference on 14 October in Birmingham was oversubscribed for the second year, with over 120 delegates booked to attend.
Abstract watch - Direct oral anticoagulants: impact on young women
Anna Dillon and Bethan Myers
pp 54-54
In this column, we feature a collection of abstracts that highlight some of the new research in the field of thrombosis, anticoagulation and clotting disorders. Research into this field is diverse and rapidly expanding, and we will endeavour to give you a sample of new findings and trends. We have collated abstracts from a number of peer-reviewed journals. Links to the full articles are provided, although you may need a subscription access to view them.
Venous thromboembolism after day surgery: an increasing problem
Anna K Lipp and Ayoola I Awopetu
pp 56-58
Day surgery is now the management pathway for the majority of patients having an elective surgical procedure. Technological advances in surgery and development of anaesthetic techniques mean that complex procedures can be carried out with minimal surgical trauma, enabling rapid mobilisation of patients and same-day discharge. However, both patients and clinicians may be unaware of the risks of venous thromboembolism (VTE) after these procedures. Additionally, as VTE prophylaxis with heparin involves daily injections, there may be a reluctance to provide this for patients once they have been discharged. In this article, we will discuss the latest guidance from the National Institute for Health and Care Excellence about the management of risks of VTE after day surgery, and the results of work we have carried out at the Norfolk and Norwich University Hospital to identify the rate of VTE after day surgery, and specific patient groups and procedures that are at higher risk.
A nurse-led direct oral anticoagulant clinic in primary care
Donna Sydenham
pp 59-61
Stroke is associated with rates of high mortality and long-term morbidity and a significant financial burden. Two studies by the London School of Economics with colleagues from King's College, London, aimed to quantify the costs. They estimated, including yearly informal care and productivity losses, a cost of £8.9 billion to the economy, concluding that cost-effective provision of care could be improved and further research is needed to ensure efficient use of resources. It is now widely accepted that atrial fibrillation (AF) is a significant risk factor for stroke and that AF-related strokes are likely to be more serious than non-AF related strokes.

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)