Pulmonary embolism and new anticoagulants

Bruxelles Woluwe

  1. For many years, pulmonary embolism has been the subject of clinical research in our center, this potentially life-threatening disease represents a significant diagnostic, therapeutic and prognostic challenge for emergency physicians and for the 60,000 new patients diagnosed each year in Belgium. These different challenges are aimed in local or international clinical studies published in leading medical journals. In 2017, we began a phase 1 randomized clinical trial that will assess the efficacy and safety of a new treatment for pulmonary embolism that could destroy the blocked clot in the pulmonary artery without inducing a serious bleeding.
  2. Monitoring and managing the Direct Thrombin Inhibitor Anticoagulation (DOAC) during the perioperative anesthetic period. This area of ​​clinical research is targeted by several local, national and international prospective studies focusing on the tricky perioperative management of patients using oral anticoagulants: (1) monitoring hemorrhagic and thromboembolic events; (2) validating the biological tests; (3) validating the interruption of the DOACs before starting locoregional anesthesia; (4) improving the advices provided during the anesthetic consultation for the perioperative management of the DOACs.
  3. Antidotes to DOAC-type anticoagulants: The Cliniques Universitaires Saint-Luc (CUSL) are one of the only hospitals in the world currently involved in the prospective evaluation of two antidotes used for severe bleeding or when urgent surgery is required for patients taking anticoagulants of DOAC type. The development of antidotes for DOACs is an important area of ​​current international clinical research. Two different types of antidotes have been developed by the pharmaceutical industry. Their mechanism of action is explained in the attached video.

Short video on anticoagulant antidotes and the challenges of clinical research in emergency care: