Bleeding and clotting disorders
Duke’s hematology program is a leader in the Southeast for diagnosing, evaluating, treating and managing all types of bleeding and clotting disorders including von Willebrand disease, hemophilia, deep vein thrombosis and pulmonary embolism. We conduct research to better understand and treat these and other blood disorders, and partner with Duke specialists to provide the most advanced and comprehensive care in the region.
Comprehensive care for bleeding and clotting disorders
Our team approach, comprehensive care, and emphasis on preventing complications related to bleeding and clotting disorders will help provide you with the best care.
Choose Duke for your care because we offer:
- Access to clinical trials. Our doctors are involved in numerous clinical trials aimed at improving treatments for people with blood and clotting disorders. You may have the opportunity to participate in our ongoing clinical trials to test these new therapies and surgical approaches before they become widely available at other centers.
- Treatment of rare clotting disorders. Our specialists see patients with unusual and uncommon disorders. We coordinate your care with other specialists throughout Duke.
- A team of specialists. Our team approach and emphasis on preventing complications will help provide you with the best care.
- Expertise in blood conditions unique to women. Duke’s Women’s Hemostasis and Thrombosis Clinic coordinates the special care required by women with bleeding and clotting disorders. We have the expertise and experience to help you manage the increased risks associated with pregnancy and childbirth.
BLEEDING AND CLOTTING DISORDERS
Treatments
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If you have low levels of von Willebrand factor, which allows blood to clot, medication may be prescribed to increase or replace this clotting factor or prevent the breakdown of blood clots. Women may need medications to control heavy menstrual bleeding.
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Blood thinners like heparin and warfarin decrease your blood’s ability to clot or prevent a blood clot from getting bigger. New medicines, including rivaroxaban and dabigatran, have been recently approved for the treatment of various disorders associated with blood clots. You may be given medicines that interfere with the blood-clotting process or dissolve large blood clots. Doctors can also insert a filter into the large vein known as the vena cava to stop blood clots before they can travel to your lungs.
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Replacement concentrates of clotting factor VIII may be given to people when levels are low, or missing in people with hemophilia A. Replacements of clotting factor IX may be given to when low levels are found in those with hemophilia B. Other drugs stimulate the release of stored factor VIII in your blood or prevent clots from breaking down during replacement therapy.
BLEEDING AND CLOTTING DISORDERS
Tests
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Examine the various types of cells in your blood, check clotting factors related to a bleeding or platelet disorder, or identify inherited blood clotting disorders that can cause deep vein thrombosis, a clot that forms in one of the body’s deep veins. Other blood-based tests are used to monitor treatment and to help you manage chronic blood-related conditions. Your blood may also be examined under a microscope to assess your platelets.
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A bone marrow sample is removed from your hipbone. This test may reveal characteristics that help your doctor determine the best course of treatment.
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Ultrasound, which uses sound waves to create pictures of blood flowing through the arteries and veins in the leg, is used to check for deep vein thrombosis. Other imaging tests, such as CT or MRI scans, take pictures of your organs and tissues that may be affected by blood disorders.
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Measures a substance in blood that is produced when a blood clot dissolves. This can be helpful in detecting deep vein thrombosis.
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Depending on your disorder, you may require additional tests on an on-going basis. If you have a blood clotting disorder, you may need regular blood tests to monitor your medication.