Clot, Clot, Who's There?
Explore the world of thrombosis and hemostasis with "Clot Clot, Who's There?", a thought-provoking podcast brought to you by Vasculearn Network in collaboration with the Thrombosis and Haemostasis Editors (Thieme).
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Is Anticoagulation Still on Board? Rapid FXa Assessment
08/01/2026
Is Anticoagulation Still on Board? Rapid FXa Assessment
Your patient is bleeding or needs urgent surgery, but no one knows when the last DOAC dose was taken. Is there still enough factor Xa inhibitor on board to change what happens next? Join experts Alex Spyropoulos, Christopher Baugh, and Deborah Siegal as they discuss: • Why stabilization must come before laboratory confirmation • The limitations of routine coagulation tests • How to interpret drug-specific and heparin-calibrated anti-Xa assays • Practical pathways for major bleeding and urgent surgery • The future of rapid point-of-care testing Tune in now and subscribe to Clot, Clot, Who’s There? for more expert conversations in thrombosis, hemostasis, and vascular medicine. 00:00: Assessing Residual Factor Xa Activity 03:41: Stabilize First, Test Second 08:56: Lab Testing: Options and Limitations 18:20: Major Bleeding vs. Urgent Surgery 21:54: The Future of Point-of-Care Testing Thank you to our sponsor, VarmX, for their generous support of this podcast episode. Check out the companion learning course, No Time To Wait: Urgent Situations in Patients on Factor Xa Inhibitors, .
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Bleeding vs. Clotting: The Periprocedural Tightrope in Patients on Factor Xa Inhibitors
08/01/2026
Bleeding vs. Clotting: The Periprocedural Tightrope in Patients on Factor Xa Inhibitors
Factor Xa inhibitors have transformed anticoagulation, but urgent bleeding or surgery may require decisions before clinicians know when the last dose was taken or how much anticoagulant activity remains. Join experts Alex Spyropoulos, Eduardo Ramacciotti, and Preston Hewgley as they discuss: • Why residual factor Xa inhibitor activity matters in urgent care • How an unknown last dose complicates clinical decisions • Why bleeding risk persists despite DOAC advantages over warfarin • How to balance bleeding, thrombosis, and surgical urgency Tune in now and subscribe to Clot, Clot, Who’s There? for more expert conversations in thrombosis, hemostasis, and vascular medicine. 00:00: Residual Factor Xa Activity: Why It Matters 01:38: Unknown Last Doses and Urgent Decisions 09:47: Major Bleeding and Urgent Surgery 14:03: Reversal, Treatment Delays, and Outcomes Thank you to our sponsor, VarmX, for their generous support of this podcast episode. Check out the companion learning course, No Time To Wait: Urgent Surgery in Patients on Factor Xa Inhibitors, .
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The COBRRA Trial and the Questions that Remain
07/01/2026
The COBRRA Trial and the Questions that Remain
The COBRRA Trial and the Questions that Remain Clinicians have long relied on indirect comparisons when choosing between direct oral anticoagulants (DOACs) for VTE. The COBRRA trial changed that. Join experts Behnood Bikdeli, Lana Castellucci, and David Jiménez as they discuss: • The landmark COBRRA trial and its implications for VTE treatment • How bleeding risk, adherence, and patient preferences influence DOAC selection • When alternatives to apixaban may still be preferred • The challenges of conducting head-to-head anticoagulation trials • Global barriers to DOAC access and the next unanswered questions in the field Tune in now and subscribe to Clot, Clot, Who's There? for more expert conversations bridging science, practice, and global perspectives in thrombosis, hemostasis, and vascular medicine. 00:00: Introduction to COBRRA and the First Head-to-Head DOAC Comparison 03:58: Apixaban vs. Rivaroxaban: Key Findings and Clinical Implications 09:45: Adherence, Special Populations, and Choosing the Right DOAC 14:18: Why Did It Take So Long? Designing and Conducting the COBRRA Trial 19:05: Global Access, Reimbursement Challenges, and Real-World Use of DOACs 23:12: The Next Frontier: COBRRA-AF and Remaining Research Questions
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Thoracic Outlet Syndrome: Evidence vs. Experience
06/01/2026
Thoracic Outlet Syndrome: Evidence vs. Experience
When a young, otherwise healthy patient presents with an upper extremity DVT, venous thoracic outlet syndrome should be high on the differential—but the diagnosis is often delayed or missed. Join experts JoMarie Monzon, MSN, FNP-BC and Drs. Donna Bahroloomi, Ali Azizzadeh, and Vincent Jongkind as they discuss: Why venous thoracic outlet syndrome is frequently mistaken for musculoskeletal injury Diagnostic challenges and the role of imaging Current approaches to thrombolysis, decompression, venous reconstruction, and anticoagulation Tune in now and subscribe to Clot, Clot, Who’s There? for more expert conversations bridging science, practice, and global perspectives in thrombosis, hemostasis, and vascular medicine. 00:00: Introduction to Venous Thoracic Outlet Syndrome (VTOS) 05:37: Diagnosing VTOS & Understanding the Different Subtypes 10:26: Thrombolysis, Anticoagulation, and Timing of Decompression 14:45: Surgical Approaches, Vein Reconstruction, and Long-Term Outcomes 22:20: Postoperative Anticoagulation Strategies 24:28: Key Clinical Takeaways
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Inside the Lab: Bypassing Factor Xa Inhibitors
05/01/2026
Inside the Lab: Bypassing Factor Xa Inhibitors
In urgent, high-stakes situations—like major bleeding or emergency surgery—how should clinicians assess coagulation in patients on factor Xa inhibitors? And more importantly, are we focusing on the right signal? Join global experts as they explore: Why traditional assays (PT/aPTT, anti-Xa) often fall short in critical decision-making The role of functional testing in assessing true hemostatic potential How VMX-C001, a novel bypassing agent, challenges conventional approaches to reversal and monitoring Be sure to read the VMX-C001 study discussed in the episode: Tune in now and subscribe to Clot, Clot, Who’s There? for more expert conversations bridging science, practice, and global perspectives in thrombosis, hemostasis, and vascular medicine. Chapters 00:00 Introduction & Clinical Challenge 02:54 Assessing Factor Xa Inhibitors in Urgent/Emergent Situations 05:29 Why Standard Assays Fall Short 09:38 Functional Testing: dPT & dRVVT 12:35 VMX-C001 & Future Directions This episode was made possible through generous support from VarmX.
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Stopping the Second Stroke: Emerging Strategies in Secondary Prevention
04/01/2026
Stopping the Second Stroke: Emerging Strategies in Secondary Prevention
Surviving a stroke is only the beginning. Preventing the next one is where the real clinical challenge lies—and for patients with non-cardioembolic stroke, the existing toolkit has long fallen short. Join Drs. Geoff Barnes, Mike Sharma, and Valeria Caso as they explore: Stroke subtypes, recurrence risk, and the unique challenges of non-cardioembolic stroke and ESUS Why current treatment options have fallen short—and what may be next The advent of Factor XI inhibitors and what emerging data may mean for the future of secondary prevention Tune in now and subscribe to Clot, Clot, Who's There? for more expert conversations bridging science, practice, and global perspectives in thrombosis, hemostasis, and vascular medicine. 00:00: Introduction & Stroke Subtypes 03:59: Recurrence Risk & Key Risk Factors 07:24: Current Treatment Strategies 10:54: ESUS & Limits of Anticoagulation 14:19: Moving Beyond Aspirin 16:26: Factor XI Inhibitors: Data & Future Directions This episode was made possible through generous support from Bayer.
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Precision Over Prescription: Antithrombotic Therapy and CAD
03/02/2026
Precision Over Prescription: Antithrombotic Therapy and CAD
When it comes to antithrombotic therapy in coronary artery disease, the central question is no longer “What should everyone get?” It’s “What’s right for this patient?” In this episode, Drs. Heather Johnson, Ty Gluckman, and Davide Cappodano explore the modern balance between managing clotting and bleeding risk in patients on antiplatelets and anticoagulants. From the evolving role of aspirin and P2Y12 monotherapy to dual pathway inhibition and the management of CAD with atrial fibrillation, the conversation highlights a clear shift: less one-size-fits-all medicine, more individualized—and shared—decision-making. Tune in now and subscribe to Clot, Clot, Who’s There? for more expert conversations bridging science, practice, and global perspectives in thrombosis, hemostasis, and vascular medicine. 00:00 – Welcome & Introduction 03:57 – Is Aspirin Still King? 10:26 – Shorter DAPT, Earlier Monotherapy 14:09 – When More Is More: the COMPASS regimen 17:49 – When Less Is More: CAD + AF
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AF Gone, Clot Still Knocking?
02/09/2026
AF Gone, Clot Still Knocking?
In this episode of Clot, Clot, Who’s There? Drs. Christian Ruff (USA) and Giulio Francesco Romiti (Italy) chat about long-term anticoagulation management after successful atrial fibrillation ablation. They explore why stroke risk may persist despite rhythm control, examine emerging evidence from the ALONE-AF and OCEAN trials, and consider how patient selection and shared decision-making should inform post-ablation care. Tune in now and subscribe to Clot, Clot, Who’s There? for more expert conversations bridging science, practice, and global perspectives in thrombosis, hemostasis, and vascular medicine. 00:00 Welcome & Introductions 01:12 Why Stroke Risk Persists After AF Ablation 04:19 The Anticoagulation Dilemma: Guidelines, Risk & Patient Priorities 09:45 New Evidence After Ablation: ALONE-AF & OCEAN 27:12 Key Takeaways, Shared Decision-Making & What’s Next
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What's Clotting in 2026?
01/07/2026
What's Clotting in 2026?
In this episode of Clot Clot Who’s There, Aviva Schwartz, Director of Education at Vasculearn Network, speaks with Professor Gregory Lip about key anticoagulation and atrial fibrillation data from 2025 and what lies ahead in 2026. The discussion spans post–AF ablation management, holistic AF care, and emerging factor XI inhibitors shaping the future of thrombosis management. Tune in now and subscribe to Clot, Clot, Who’s There? for more expert conversations bridging science, practice, and global perspectives in thrombosis, hemostasis, and vascular medicine. Chapters: 00:00 Welcome and Introduction 01:59 2025 Trial Highlights: Anticoagulation in Stable CAD and AF Ablation 07:27 High-Risk AF and Holistic Care 10:10 What’s Coming in 2026: Factor XI Inhibitors and Upcoming Trials 11:51 Guidelines vs. Real-World Practice
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A Bridge Too Far? Navigating Perioperative Anticoagulation Challenges in Nonurgent Procedures
12/01/2025
A Bridge Too Far? Navigating Perioperative Anticoagulation Challenges in Nonurgent Procedures
Host Dr. Alex Spyropoulos is joined by global experts Drs. James Douketis and Marc Samama for a focused, practical discussion on perioperative anticoagulation management in nonurgent procedures. Together, they clarify: When and how to safely interrupt warfarin and direct oral anticoagulants Why heparin bridging is now rarely needed How procedural bleeding risk and pharmacokinetics inform decision-making The episode reviews evidence from key clinical trials, outlines when anticoagulation can safely be continued for minimal-bleed-risk procedures, and explores future directions—including the potential role of Factor XI inhibitors in the perioperative setting. Don’t miss this concise, guideline-driven conversation for clinicians managing anticoagulated patients or working within perioperative care teams. Tune in now and subscribe to Clot, Clot, Who’s There? for more expert conversations bridging science, practice, and global perspectives in thrombosis, hemostasis, and vascular medicine. 00:00 – Welcome & Introductions 02:34 – Assessing Thrombotic vs. Bleeding Risk 08:56 – Warfarin Interruption & Bridging: What Changed? 16:39 – DOAC Management 23:34 – Procedure Playbook for Low Bleed Risk 29:29 – Future Directions: Factor XIs and Beyond
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Antithrombotic Stewardship
10/30/2025
Antithrombotic Stewardship
Host Tara Lech is joined by Drs. Scott Woller and Virginia Silvari for a thoughtful conversation on anticoagulation stewardship: what it is, why it matters, and how it can help patients who need antithrombotic therapy. They share examples from their own practice, talk through common challenges, and offer simple steps for improving care across settings. Topics: What makes anticoagulation stewardship different from traditional management How to choose the right anticoagulant for each patient Practical system-level steps to support safe prescribing Lessons from U.S. and European practices Tips for reassessing therapy and managing periprocedural care Tune in now and subscribe to Clot, Clot, Who’s There? for more expert conversations bridging science, practice, and global perspectives in thrombosis, hemostasis, and vascular medicine. 00:00 Welcome & Setting the Stage 02:01 What "Antithrombotic Stewardship" Really Means 05:49 Choosing the Right Agent for the Right Patient 13:39 Reassessment, Follow-Up, & Real-World Impact 22:50 Perioperative Management & Building a Stewardship Culture
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Recent Advances in Immunothrombosis & Thromboinflammation
09/29/2025
Recent Advances in Immunothrombosis & Thromboinflammation
Join host Christian Weber, MD (LMU Munich) with vascular biology experts Kimberly Martinod, PhD (University of Rochester) and Konstantin Stark, MD (LMU Munich) as they explore the evolving science of immunothrombosis and thromboinflammation—concepts that rose to prominence during COVID-19 but reach far beyond infectious disease. Learn about: How thrombotic and inflammatory mechanisms impact cardiovascular disease, sepsis, and beyond Emerging biomarkers and therapies with the potential to improve patient outcomes The critical role of scientist–clinician collaboration in translating discoveries into care For cardiologists, hematologists, critical care specialists—or anyone curious about immunity, clotting, and inflammation—this conversation provides both foundational insight and a forward-looking perspective. Tune in now and subscribe to Clot, Clot, Who’s There? for more expert conversations bridging science, practice, and global perspectives in thrombosis, hemostasis, and vascular medicine. 00:00 Welcome and Introductions 01:38 Immunothrombosis vs Thromboinflammation 04:00 How Cells & Molecules Interact 10:20 Clinical Impacts Across Diseases 13:29 Biomarkers & Translational Gaps 17:14 Emerging Therapies 22:04 Key Takeaways & Future Directions
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When Time is Limb: Acute Limb Ischemia and Thrombotic Emergencies
08/28/2025
When Time is Limb: Acute Limb Ischemia and Thrombotic Emergencies
Join JoMarie Monzon, NP (Cedars-Sinai, Vasculearn Network) as she welcomes moderator Dr. Cassra Arbabi and guests Drs. Donald Baril (Cedars-Sinai) and Efthymios (Makis) Avgerinos (Athens Medical Center) for a high-stakes discussion on acute limb ischemia (ALI). Explore U.S. and European approaches to this vascular emergency—from recognition to revascularization—and gain practical, globally informed insights on saving limbs and lives. Topics covered: Recognizing the “six Ps” of ALI Why urgency is critical Imaging pathways in the U.S. and Europe Open vs. endovascular strategies, including thrombolysis Anticoagulation and supportive therapy Future directions in ALI management Tune in now and subscribe to Clot, Clot, Who’s There? for more expert conversations bridging science, practice, and global perspectives in thrombosis, hemostasis, and vascular medicine. 00:00 Introduction & Patient Case 05:05 Defining ALI and Why Time Is Limb 09:21 ALI Diagnosis & Early Management 13:47 Treatment Pathways 26:30 Beyond the OR 30:56 Key Takeaways
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Conversations that count: Communicating with patients about anticoagulation
06/24/2025
Conversations that count: Communicating with patients about anticoagulation
Dr. Bethany Samuelson Bannow is joined by Dr. Erik Klok and Dr. Geoff Barnes for a discussion on the best ways to communicate with your patients about anticoagulation. Anticoagulation therapy is a cornerstone of care for patients, but starting and managing these medications can be overwhelming for patients. In this episode, we’ll cover common patient questions, tips for improving adherence, how to discuss lifestyle considerations and considering shared decision-making. Today’s episode is presented by the ISTH in partnership with Vasculearn Network. Vasculearn’s podcast “Clot, Clot, Who’s There?” is produced in partnership with the editors of the journal Thrombosis and Haemostasis at Thieme.
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Global Rhythm: US and European Atrial Fibrillation Guidelines Head-to-Head
05/28/2025
Global Rhythm: US and European Atrial Fibrillation Guidelines Head-to-Head
Join Dr. Jose Joglar, Chair of the 2023 U.S. AFib Guidelines, and Professor Gregory Lip, Chair of the ESC Council on Stroke, as they dive into the latest U.S. and European atrial fibrillation guidelines. From risk scores to rhythm control, they explore common ground, key differences, and the global shift toward holistic, patient-centered care. (Hint: coffee lovers with AFib, rejoice!) Whether you’re a clinician navigating daily treatment decisions or a curious learner keeping up with cardiology guidelines, this is a must-listen conversation that reveals how far we’ve come in managing AFib and where we’re headed next. Topics covered: Point-of-care pathways Anticoagulation and evolving risk scores Early rhythm control strategies Addressing AFib as a cardiometabolic disease Long-term impacts and future research priorities Tune in now and subscribe to stay updated in expert insights in thrombosis and cardiovascular medicine! For more resources, check out: ESC Guidelines: Clinician Perspective: 2024 ESC Guidelines: 2023 U.S. Guidelines: 00:00 Introduction 01:57 Philosophies Behind AFib Guidelines 08:11 Lifestyle and Prevention in AFib 08:58 Evidence for Holistic Care: mAFA & MIRACLE Trials 12:34 Stroke Risk Scores and Future Research Needs 17:29 Rhythm vs Rate Control: Evolving Practice 20:56 Ablation, Drug Therapy, and Shared Decision-Making 22:12 The Caffeine Myth 24:31 Key Takeaways
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Risky Business: Stratifying VTE and Managing Anticoagulation
04/25/2025
Risky Business: Stratifying VTE and Managing Anticoagulation
Join host Dr. Kerstin de Wit as she welcomes Drs. Cecilia Becattini and Behnood Bikdeli to unpack one of the most nuanced challenges in thrombosis care: venous thromboembolism (VTE) risk stratification and anticoagulation management. This case-based conversation explores: How clinicians navigate decisions around continuing, reducing, or stopping anticoagulation Whether formal risk scores or D-dimer testing guide us—or just add noise The complexities of provoked vs. unprovoked VTE Approaches to shared decision-making Novel therapies on the horizon Tune in now and subscribe to stay updated in expert insights in thrombosis and cardiovascular medicine!
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Sex as a Risk Factor for AF-related Stroke
02/19/2025
Sex as a Risk Factor for AF-related Stroke
Does sex influence the risk of atrial fibrillation (AF)-related strokes? Is female sex truly an independent risk factor? And what common myths still cloud clinical understanding? In this episode, host Dr. Giulio Francesco Romiti (internal medicine specialist from Sapienza University of Rome, Italy) is joined by guests Dr. Geoff Barnes (cardiologist and vascular medicine specialist, University of Michigan, USA) and Dr. Bernadette Corica (internal medicine specialist and cardiologist in training in Modena, Italy, and honorary research fellow at the Liverpool Centre for Cardiovascular Science, UK) to explore the complex relationship between sex and stroke risk in patients with AF. Together, they unpack the latest research, challenge myths and misconceptions, and provide key insights on: ✅ Sex disparities in AF prevalence and stroke incidence✅ Why women with AF may experience worse outcomes✅ The role of anticoagulation therapy in men vs. women✅ Practical clinical strategies for stroke prevention Whether you're a clinician, researcher, or healthcare professional, this episode offers essential takeaways for optimizing patient care. 🎧 Tune in now and subscribe to stay updated on expert insights in thrombosis and cardiovascular medicine!
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The Burden of Atrial Fibrillation
01/29/2025
The Burden of Atrial Fibrillation
In this inaugural episode of Clot Clot Who’s There, global experts Professor Tatjana Potpara (Serbia), and Dr. Annabelle Volgman (USA) join moderator Dr. Panteleimon Papakonstantinou (Ireland) to discuss the rising global prevalence of atrial fibrillation (AF), a leading contributor to strokes and heart failure. They explore regional differences in AF management, evolving guidelines, and the potential of new treatments and technologies. With a focus on prevention, disparities in care, and the importance of early and individualized interventions, this discussion highlights critical pathways to improving outcomes for AF patients worldwide.
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