Stroke survivors know that if the universe could fire bullets, then they’ve just dodged one. So the increased possibility of another stroke brings on a rush of emotions, concerns, and worries: you got through it once. Youre strong. But how many times can you roll the dice before the outcome isn’t so favorable?
With any luck, your doctor will note your risks ahead of time, and you go into prevention mode. Your doctor will like prescribe either anticoagulation therapy or IVC filters. Let’s dive into both.
Anticoagulant therapy work in a few different ways. The popular and ubiquitous warfarin (marketed as Coumadin) works by stopping vitamin K from making blood coagulation proteins (including prothrombin and factor VII). It’s effective yet dangerous: if you eat a salad, you could overload your system with vitamin K, which would then overpower the warfarin and cause you to clot. It takes time and energy to monitor.
Factor Xa inhibitors like rivaroxaban (marketed as Xarelto) work differently. They work by blocking your blood cells from connecting with thrombin, which means that it doesn’t matter how much vitamin K you have in your system. The vitamin K can produce all the clotting proteins it wants, because it will never bind to your cells. That means you need much less monitoring while on the factor Xa inhibitors, but it also means that there is no antidote. Lawsuits are currently pending and under litigation claiming that rivaroxaban caused massive internal hemorrhaging in thousands of people.
Despite the potential dangers, the American College of Chest Physicians (ACCP) guidelines state that anticoagulation therapy can reduce mortality rates from 30% to less than 10%. These treatments include a series of pharmaceutical drugs and oral anticoagulants. When determining which anticoagulation therapy to pursue, physicians should consider:
- Clinical suspicion of a stroke
- Detection of thrombosis on clinical examination
Anticoagulation therapies are used to prevent new blood clots from forming and should be the first treatment for potential clot formation. Always ask your doctor if it is a possible route for you if they suggest you get an IVC filter to treat your risk of stroke.