The King’s Thrombosis Centre provides comprehensive care for patients with suspected/confirmed venous thromboembolism (VTE). We offer a fast-track nurse-led DVT (deep vein thrombosis) clinic which assesses patients who present directly to the hospital from the community. Patients are referred to a nurse-led clinic for rapid assessment of suspected DVT and are usually seen on the day of referral.
Following clinical assessment and diagnostic testing, those with confirmed DVT are assessed for outpatient management and then transferred directly to our anticoagulation service when appropriate. Time to diagnosis is now under two hours and patients requiring treatment are home within four hours.
In conjunction with the Acute Medical service, we provide an early discharge programme for low risk PE (pulmonary embolism). Patients are evaluated for suitability for outpatient management and may be referred to the anticoagulation clinic on the day of PE diagnosis, for ongoing outpatient care. A PE response team was established in August 2022 with our critical care, interventional radiology and respiratory colleagues. This service is available from 8am to 8pm every day and enables real-time multidisciplinary management discussion of complex patients, such as intermediate-high risk PE or those with concomitant bleeding risk factors. Specialist anticoagulation advice for inpatients is also available via our Anticoagulation MDT ward rounds conducted by a haematology consultant, specialist anticoagulation pharmacist and nurses.
All patients with VTE are reviewed soon after diagnosis by a Consultant Haematologist in a dedicated follow-up clinic where an individualised approach to management is agreed. Investigations to ascertain an underlying cause of thrombosis are performed when appropriate and optimal duration of therapy is decided upon taking into account patient preference. A monthly joint haematology/respiratory clinic with a visiting respiratory physician from Guy’s Hospital is available to review patients with persistent breathlessness following PE facilitating earlier investigation.
The Thrombosis clinic additionally provides advice on reducing the risk of complications, such as post-thrombotic syndrome and recurrent VTE, in addition to treatment when these events occur. Patients with thrombosis at unusual sites, particularly splanchnic vein thrombosis, are seen in the Thrombosis clinic to facilitate investigation for acquired prothrombotic conditions and for anticoagulation initiation/monitoring.
The following guidelines are used at King’s College Hospital for the management of VTE:
Research completed under this theme include:
- Deep Vein Thrombosis Proforma [PDF]
- Diagnosis and Management of Suspected Pulmonary Embolism [PDF]
- Superficial Vein Thrombosis and Upper Limb DVT Management [PDF]
- Protocol for the Management of Massive Pulmonary Embolism PE with Thrombolysis [PDF]
- Deep Vein Thrombosis Patient Information Leaflet [PDF]
- Pulmonary Embolism Patient Information Leaflet [PDF]
- Superficial Vein Thrombosis Patient Information Leaflet [PDF]