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Diagnostic and Prognostic Models in VTE Management: Ready for Primetime? - Live Q&A

Program: Education Program
Saturday, December 5, 2020: 9:30 AM-10:15 AM

Description:
Venous thromboembolism is responsible for a considerable morbidity and mortality burden world-wide, contributing to potentially preventable hospital-associated and pregnancy-related death. Conversely, development of validated algorithms to permit identification of patients who are potentially suitable for home treatment or those for whom diagnostic imaging may not be necessary is valuable, as these strategies may avoid competing risks of hospital admission and radiation exposure. Moreover, prediction of patients at high and low risk of VTE recurrence could permit refining of treatment duration and optimize targeting of treatment to those most likely to benefit. This session will explore the state of the art in all of these areas and address whether diagnostic and prognostic models in VTE diagnosis and management are indeed “ready for primetime”.

Dr. Erik Klok will discuss under which conditions patients with proven acute pulmonary embolism may be treated at home. He will highlight the different risk stratification tools tested in prospective studies and discuss the best clinical practice of follow-up of patients treated at home

Dr. Fionnuala Ní Áinle will discuss the circumstances in which VTE events may occur and how these risk factors determine future VTE recurrence risk. She will review the evidence for which circumstances are associated with highest predicted VTE recurrence risk. She will discuss gender-based differences in recurrence risk including considerations while caring for women with hormone or pregnancy-associated VTE and people who identify as transgender. She will provide an update on risk-prediction algorithms and will address whether they are “ready for prime time” or incorporation into guidelines.

Dr. Wee Shian Chan will review recent management protocols using ancillary tests in diagnostic algorithms for Pulmonary embolism in pregnancy. The strengths and limitations of these individual approaches—combination of predictions rules and D-dimer testing, to minimize the need for objective testing will be discussed. Using a case-based approach, a sensible algorithm will be explored.

Chair:
Fionnuala Ni Ainle, MD, PhD, Mater Misericordiae University Hospital and Rotunda Hospital, University College Dublin
Disclosures:
Ainle: Leo Pharma: Research Funding; Sanofi: Research Funding; Actelion: Research Funding; Bayer: Research Funding.
Panelists:
Frederikus A Klok, MD, PhD, Leiden University Medical Center , Fionnuala Ni Ainle, MD, PhD, Mater Misericordiae University Hospital and Rotunda Hospital, University College Dublin and Wee Shian Chan, MSc, MD, FRCPC, FACP, BC Women's Hospital, University of British Columbia
Disclosures:
Ainle: Bayer: Research Funding; Actelion: Research Funding; Sanofi: Research Funding; Leo Pharma: Research Funding.
Venous thromboembolism is responsible for a considerable morbidity and mortality burden world-wide, contributing to potentially preventable hospital-associated and pregnancy-related death. Conversely, development of validated algorithms to permit identification of patients who are potentially suitable for home treatment or those for whom diagnostic imaging may not be necessary is valuable, as these strategies may avoid competing risks of hospital admission and radiation exposure. Moreover, prediction of patients at high and low risk of VTE recurrence could permit refining of treatment duration and optimize targeting of treatment to those most likely to benefit. This session will explore the state of the art in all of these areas and address whether diagnostic and prognostic models in VTE diagnosis and management are indeed “ready for primetime”.

Dr. Erik Klok will discuss under which conditions patients with proven acute pulmonary embolism may be treated at home. He will highlight the different risk stratification tools tested in prospective studies and discuss the best clinical practice of follow-up of patients treated at home

Dr. Fionnuala Ní Áinle will discuss the circumstances in which VTE events may occur and how these risk factors determine future VTE recurrence risk. She will review the evidence for which circumstances are associated with highest predicted VTE recurrence risk. She will discuss gender-based differences in recurrence risk including considerations while caring for women with hormone or pregnancy-associated VTE and people who identify as transgender. She will provide an update on risk-prediction algorithms and will address whether they are “ready for prime time” or incorporation into guidelines.

Dr. Wee Shian Chan will review recent management protocols using ancillary tests in diagnostic algorithms for Pulmonary embolism in pregnancy. The strengths and limitations of these individual approaches—combination of predictions rules and D-dimer testing, to minimize the need for objective testing will be discussed. Using a case-based approach, a sensible algorithm will be explored.

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