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Obesity presents a persistent challenge in the management of cancer-associated thrombosis, particularly when prescribing low molecular weight heparin beyond standard dose caps.

In this episode of CLOT Conversations, host Dr. Jameel Abdulrehman is joined by Dr. Tzu-Fei Wang and Dr. Grégoire Le Gal to discuss findings from the WAVe study, a multicenter prospective cohort study evaluating weight-adjusted dalteparin dosing in patients over 90 kg with acute cancer-associated venous thromboembolism.

The conversation examines bleeding and thrombotic outcomes, mortality, and trough anti-Xa levels, including insights into bioaccumulation and twice-daily versus once-daily dosing. The guests also address study limitations, dose capping in patients with very high body weight, and how WAVe fits into current practice amid increasing DOAC use.

This episode provides practical, evidence-informed guidance for clinicians navigating anticoagulation decisions in obese patients with cancer.

To access the full publication: https://onlinelibrary.wiley.com/doi/full/10.1002/ajh.70127

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In this episode of CLOT Conversations, co-hosts Dr. Jamil Abdul-Rahman and Dr. Maha Othman have an in-depth discussion with leading thrombosis expert Dr. Jeff Weitz. Together, they unpack new findings from The Lancet on RGN-9933 and RGN-7508, two investigational factor XI inhibitors evaluated in the Roxy-VTE 1 and 2 phase-2 trials. These studies examine how targeted inhibition of factor XI may reduce post-operative venous thromboembolism with potentially lower bleeding risk than current anticoagulants.

Dr. Weitz explains the distinct mechanisms of the two antibodies, the role of factor XII-mediated activation in post-operative VTE, key efficacy and safety outcomes, and how these early-phase studies set the stage for ongoing phase-2 and phase-3 trials—including Roxy-CATH, Roxy-Aspirin, and emerging AF and stroke-prevention research.

This episode is essential listening for clinicians interested in the rapidly evolving landscape of anticoagulation and next-generation therapies that may offer safer options for patients undergoing orthopedic surgery and beyond.

Read the full Lancet publication by clicking on the link below and explore more thrombosis resources at thrombosiscanada.ca.

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https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)02097-5/abstract [Note: full access requires a subscription]

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Diagnosing recurrent venous thromboembolism (VTE) remains one of the biggest clinical challenges in thrombosis medicine. In this episode, Dr. Vicky Mai and Dr. Grégoire Le Gal join us to discuss the international PREDICTORS study (JTH, 2025), which evaluated the performance of commonly used clinical decision rules (Wells and Geneva scores) in patients with suspected recurrent VTE. They share why symptoms can be misleading, how residual clots complicate imaging, and what their findings mean for the safe use of D-dimer and anticoagulation status in clinical practice.

Reference:

Mai, V., Martens, E. S., Righini, M., Schulman, S., Thiruganasambandamoorthy, V., Kahn, S. R., ... & Le Gal, G. (2025). Performance of clinical decision rules in patients presenting with suspected recurrent venous thromboembolism: a multicenter prospective cohort study. Journal of Thrombosis and Haemostasis.

https://www.sciencedirect.com/science/article/abs/pii/S1538783625004088

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This episode reviews findings from a cross-sectional study at SickKids on health literacy in pediatric VTE patients and caregivers (Res Pract Thromb Haemost, 2025). Among 101 participants, 74% of adolescents and 59% of parents/caregivers demonstrated low general health literacy using REALM, HAS-A, and eHEALS instruments. Communication with providers was the most affected domain, and fewer than half of participants were satisfied with their thrombosis knowledge. Adolescents frequently overestimated their understanding, underscoring the need for simplified educational resources and a “universal precautions” approach to health literacy in pediatric thrombosis care.

AboutKidsHealth Thrombosis Hub: https://www.aboutkidshealth.ca/thrombosis

Bastas, D., Mancini, A., Wong, G., Brandão, L. R., Mukaj, S., Vincelli, J., ... & Avila, L. (2025). Health literacy in pediatric thrombosis: a landscape analysis. Research and Practice in Thrombosis and Haemostasis, 9(1), 102653.

Publication Link: https://www.rpthjournal.org/article/S2475-0379%2824%2900348-0/fulltext

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In this episode, Dr. Laura Avila and Jennifer Vincelli discuss their Blood publication on long-term outcomes of pediatric pulmonary embolism. Among 150 patients, ~30% had incomplete PE resolution and 9% experienced recurrence, but persistent sequelae were rare. True post-PE syndrome occurred in <9%, with only one case of CTEPH. The findings highlight the value of structured follow-up, attention to underlying conditions, and promoting physical activity to counter deconditioning.

To access the publication use this URL: https://thrombosiscan.info/CLOT-CONVO-46

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In this episode of CLOT Conversations, we discuss the newly developed Orthopedic Surgery VTE Thromboprophylaxis Guideline Summary. Dr. Marc Carrier, a hematologist and key author, highlights the need for a multidisciplinary approach in managing venous thromboembolism (VTE) risks, particularly in orthopedic surgery. The conversation covers preoperative risk assessments, options for pharmacological and mechanical thromboprophylaxis, and the evolving landscape of surgical techniques that influence thrombosis risk. The episode emphasizes the importance of providing clinicians with practical tools to effectively navigate VTE prevention.

Access the full review paper here: https://thrombosiscanada.ca/uploads/publications/WhitePapers/TC135_VTE_Whitepaper_v4.pdf

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In this episode of CLOT Conversations, experts discuss recent research on cancer-associated thrombosis and the predictors of recurrent venous thromboembolism (VTE) and anticoagulant-related bleeding. Dr. Faizan Khan, a leading researcher in the field, explains the results of their study that aimed to offer a comprehensive understanding of the prognostic factors associated with these risks. Hear what he says about the evidence for associations of several patient- and cancer-related factors, and the risk of recurrent VTE. This research is expected to inform clinical practice by promoting a more individualized approach to anticoagulant management in cancer patients.

Reference:

Khan, F., Tritschler, T., Marx, C. E., Lanting, V., Rochwerg, B., Tran, A., ... & Carrier, M. (2025). Predictors of recurrent venous thromboembolism and bleeding in patients with cancer: a meta-analysis. European Heart Journal, ehaf453.

https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehaf453/8170116?login=false

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Did you know that nearly 1 in 10 cancer patients worldwide may develop a potentially deadly blood clot? In this episode, we speak with researcher Jordan Harry, lead author of a landmark systematic review just published in Cancer Epidemiology, that uncovers which solid tumors carry the highest risk of venous thromboembolism (VTE) and where in the world patients are most vulnerable.

Jordan walks us through surprising insights from their analysis of over 120 studies:

🔹 Why gastroesophageal, ovarian, and brain cancers top the list for clot risk

🔹 What the data reveals about sex-based differences

🔹 How global gaps in reporting may be leaving patients behind

🔹 And what a cancer survivor told her that changed how she views her work

This isn’t just another research summary, it’s a conversation about saving lives by recognizing the often-overlooked danger of cancer-associated thrombosis. If you care about improving outcomes in oncology or want to understand the real-world impact of VTE in cancer care, this is a must-listen.

To access the ISTH Common Data Elements mentioned in this episode: https://isth.breakthrough.healthcare/

To access the Thrombosis Canada Cancer-Associated Thrombosis resources for patients: https://thrombosiscanada.ca/cancer

To access the publication: https://www.sciencedirect.com/science/article/abs/pii/S1877782125000232

Ref: Jordan Harry, Regan Bucciol, Deirdre Finnigan, Hussein Hashem, Ahmad Araki, Maha Othman, The incidence of venous thromboembolism by type of solid cancer worldwide: A systematic review, Cancer Epidemiology, Volume 95, 2025, 102764,
ISSN 1877-7821, https://doi.org/10.1016/j.canep.2025.102764.

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Take a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada