SVM-AVF Session: COVID Clots, Edema and Thrombophilia

Covid-19 Thromboinflammation and Anticoagulation

Yogen Kanthi described neutrophil traps and prothrombotic autoantibodies driving Covid 19 thrombosis, while John Fish found full dose anticoagulation reduced organ support needs in moderately ill patients but showed no benefit and possible harm in critically ill patients.

Obesity and Phlebolymphedema

Stephen Dean linked morbid obesity to phlebolymphedema through attenuated venous velocity and shear stress independent of reflux, plus calf pump dysfunction from reduced activity, producing fibrotic skin changes including elephantiasis nostras verrucosa in severely obese patients.

Cancer-Associated Thrombosis: A Bleeding and Clotting Balance

Anna Gasecka described cancer associated thrombosis as multifactorial, with gastrointestinal, pancreatic, and hematologic cancers carrying higher recurrence risk while genitourinary and lung cancers carry higher bleeding risk, complicated by anticoagulant interactions with chemotherapy.

Nonvascular Edema Workup and Thrombophilia Testing

One talk outlined a history, exam, and lab workup for nonvascular limb swelling from causes like heart failure and medications, while another argued hypercoagulable testing should be reserved for unprovoked or weakly provoked clots, avoided during acute thrombosis.