CLOT Conversations
Unlock the latest breakthroughs in thrombosis diagnosis and management with CLOT Conversations - the must-listen podcast for healthcare professionals. Join hosts Dr Jameel Abdulrehman, a Hematologist with specialization in Thrombosis and Hemostasis at the University Health Network in Toronto, and David Airdrie, the Executive Director of Thrombosis Canada, as they delve into new research and explore the evolving field of thrombosis in 15 to 30 minute easily digestible episodes. Learn from the experts and stay ahead of the curve with Thrombosis Canada, the organization dedicated to promoting excellent patient care and improved outcomes for patients with thrombosis. Access our vast resources, tools, and programs at https://thrombosiscanada.ca and stay informed with CLOT Conversations - your go-to source for all things thrombosis.
CLOT Conversations
EPCAT III: Is Aspirin Alone Enough After Hip or Knee Arthroplasty?
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Is aspirin alone enough to prevent venous thromboembolism after total hip or knee arthroplasty?
In this episode of CLOT Conversations, Dr. Jameel Abdulrehman speaks with Dr. Sudeep Shivakumar, lead author of the EPCAT III trial, recently published in the New England Journal of Medicine.
EPCAT III randomized more than 5,400 patients undergoing hip or knee arthroplasty to receive aspirin alone or rivaroxaban for five days followed by aspirin. Dr. Shivakumar discusses the study's findings, including the low rates of symptomatic VTE observed in both groups, bleeding outcomes, the significance of distal DVT, and how EPCAT III builds on the earlier EPCAT trials.
They also explore whether modern surgical care has changed the baseline risk of VTE following arthroplasty and which higher-risk patients may still warrant an anticoagulant-based approach.
A practical discussion about translating an important Canadian clinical trial into individualized thromboprophylaxis decisions.
Reference:
Shivakumar, Sudeep, et al. "Rivaroxaban Then Aspirin vs. Aspirin Alone after Total Hip or Knee Arthroplasty." New England Journal of Medicine (2026). https://www.nejm.org/doi/abs/10.1056/NEJMoa2603649
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