What's Clotting in 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

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

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: https://www.rpthjournal.org/article/S2475-0379(26)00033-6/fulltext?dgcid=raven_jbs_etoc_email [https://www.rpthjournal.org/article/S2475-0379(26)00033-6/fulltext?dgcid=raven_jbs_etoc_email] 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.

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.

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