Stroke survivors know that if the universe could fire bullets, they’ve just dodged one. Imagining another stroke brings a rush of emotions, concerns, and worries: you got through it once. You’re 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 and devise a preventive treatment plan. Your doctor will likely recommend either anticoagulant therapy or an IVC filter. Let’s dive into both.
Anticoagulant therapy works in a few different ways. Warfarin (marketed as Coumadin) prevents vitamin K from making blood clotting proteins (including prothrombin and factor VII). It’s effective, yet dangerous: Eating a salad could overload your system with vitamin K. Too much vitamin K overpowers warfarin’s blood-thinning effects, causing blood clots. It also takes time and energy to monitor.
The American College of Chest Physicians (ACCP) guidelines state that anticoagulant 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 anticoagulant 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.
Your risk of a blood clot increases after major surgery, such as hip surgery. If you’ve undergone surgery or had another injury, your doctor may determine that blood thinners are not wise to use while your body is healing. You could develop severe internal bleeding.
If you can’t use anticoagulant therapy, your doctor may recommend a retrievable inferior vena cava filter, or IVC filter. Your doctor may suggest one if anticoagulant therapy fails to treat your acute proximal venous thrombosis.
IVC filters are simple in theory: they have arms that open up inside your veins to catch blood clots in your lower body before they can travel to your heart, lungs, or brain. But they are more complicated in practice for three reasons:
- Complications at insertion can be fatal.
- The filter can become a danger if left in for too long, though the FDA has said not all retrievable IVC filters are “retrievable” after all.
- IVC filters have at times traveled to different areas of the body and cause infection, perforation of organs and other potentially fatal side effects.
In May 2014, the FDA released a warning to physicians stating that they have received reports of adverse events related to IVC filters. Reports included device migration, fracture, embolization, perforation, and difficulty removing the device.
How to Stay Safe
Talk to your doctor about the pros and cons of each type of treatment so that you know you are making the most educated decision about your health.
Jared Heath is the author of The Sound in the Silence. In his role as an SEO content and digital marketing strategist, Jared was directly responsible for managing DrugJustice.com's editorial calendar and published articles on this website from 2015 to 2016. He is now pursuing a new career as a chiropractor.