![]() The etiology of increased risk of VTE in SCD patients is multifactorial and is related to both traditional factors and SCD-specific factors. Objective To determine if the use of SCD prevents VTE in medically ill hospitalized patients. Venous thromboembolism (VTE) is common in patients with sickle cell disease (SCD). The need for VTE prophylaxis in patients on chronic treatment with aspirin and/or clopidogrel should be evaluated after assessing the individual risk-benefit ratio. Mechanical methods of VTE prevention such as sequential compression devices (SCD) are used mostly in combination with AC or in patients with high risk of bleeding. Sequential Compression Device (SCD) is a method of DVT prevention that improves blood flow in the legs. Studies in stroke suggest that thromboprophylaxis with heparins is safe in patients with ischemic stroke undergoing aspirin treatment. Aspirin treatment is not as effective as heparins in lowering the risk of VTE. Except in cases with contraindications to anticoagulation, antithrombotic prophylaxis should be always considered in hospitalized cancer patients with thrombocytopenia, especially in those with hematologic malignancies and multiple VTE risk factors. VTE prophylaxis in high-risk conditions is thus suggested in these patients. In patients with antiphospholipid antibodies and thrombocytopenia, a thrombotic tendency is usually associated rather than a bleeding risk. In severe thrombocytopenia, prophylaxis should be considered on an individual basis, however. At variance with severe thrombocytopenia ( 50,000/μL) should not interfere with VTE prevention decisions. However, these patients have a high incidence of portal and idiopathic venous thromboses, implying that cirrhotic coagulopathy does not protect against thrombosis. Low platelet number/function and clotting abnormalities are common in patients with liver cirrhosis. Because at least 25% of subjects admitted to medical departments exhibit these conditions, information on this subject is provided here to optimize their VTE prophylaxis. Thus no specific recommendation/algorithm for pharmacological prophylaxis in patients with thrombocytopenia and/or platelet dysfunction is available. ![]() Current guidelines for venous thromboembolism (VTE) primary prophylaxis are based on randomized clinical trials that exclude subjects at a potentially high bleeding risk. ![]()
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