Sickle cell disease: managing thromboembolism

Sickle cell disease (SCD) is an acquired hypercoagulable state defined by the presence of prothrombotic alterations of the coagulation system, increased platelet activation, and endothelial disruption. These changes are associated with increased incidence of venous thromboembolism (VTE). There is interest in investigating the role of primary thromboprophylaxis, especially with the use of central venous catheters, perioperatively and during the last trimester of pregnancy and postpartum. Like the general population of patients with VTE, direct oral anti-Xa antagonists are being widely used as anticoagulation for secondary prophylaxis.