Venous thromboembolism (VTE) – also known as deep vein thrombosis (DVT) – is a significant and global health issue with rising prevalence in many regions, particularly the Middle East. In this article, Bernard Ross, CEO at Sky Medical Technology, tells us how MedTech can support VTE management.
VTE is both dangerous and comes with a high economic burden. It occurs when a blood clot forms in a deep vein – typically in the leg – slowing and blocking effective blood flow. Often considered a silent killer due to its quick development and lack of symptoms, it can spiral into more severe cases as blood clots travel from the leg to more essential organs such as the lungs. This can result in a life-threatening pulmonary embolism (PE) which can trigger a stroke or heart attack.
Awareness, identification and prevention
Recent clinical data exploring VTE prevalence in the Middle East focuses on Saudi Arabia, the largest nation in the Middle East. A recent study found that VTE levels are high in Saudi Arabia, particularly compared to other regions. It is the leading cause of morbidity and mortality among hospitalised patients in the country – with risk appearing to increase the longer a patient stays in hospital. Despite this, awareness of blood-clot related conditions and the subsequent risks is low. In fact, a 2023 survey further revealed that only 18.6% of Saudi Arabian’s were aware of DVT. What’s more, the majority of respondents believed that having a blood clot was not considered a medical emergency.
Although globally prevalent and dangerous, VTE is entirely preventable particularly in the hospital setting. Through thromboprophylaxis, at-risk hospitalised patients can be monitored and prescribed preventative methods to eliminate the chance of developing blood clots whilst recovering from other conditions in hospital. However, the management of VTE is considered to lack standardisation in parts of the Middle East, with significant variability in the implementation of thromboprophylactic methods in the nation’s hospitals.
Moreover, a Middle Eastern (AVAIL ME) study explored patients at risk for VTE to identify the rate of patients receiving appropriate prophylaxis in the Middle Eastern region. The study investigated more than 2,000 patients and found that patient compliance to VTE guideline-based thromboprophylaxis was as low as 40.1% in medical patients and 36.4% in surgical patients, indicating a large unmet need for at-risk patients across the region.
Understanding the risks
In parts of the Middle East, VTE prevention is largely provided via pharmacological thromboprophylaxis like oral anticoagulants. These are prescribed to patients to inhibit the group of blood proteins that are responsible for clotting, thinning the blood and preventing clots altogether. However, a 2023 study exploring the clinical efficacy of VTE management in Saudi Arabian hospitals revealed that anticoagulants were associated with a higher risk of VTE recurrence. Meanwhile, a lack of adherence to anticoagulation treatment after discharge has also been observed.
In some cases, anticoagulant strategies are deemed unfit for patients – for instance, those recovering from stroke or pregnant patients often cannot be prescribed pharmacological prophylaxis as it increases the risk of extracranial bleeding and complications related to haemorrhage.
These studies combined indicate that some hospitals across the Middle East may struggle to comply with thromboprophylaxis guidelines, indicating the need for healthcare systems to look to new solutions that can ensure all patients have access to VTE preventative care. Fortunately, innovations in medical technology (MedTech) can provide low-risk and non-invasive solutions – some of which are already being adopted across the region to tackle the issues with thrombosis.
Introducing medical technology
Innovation, such as a wearable neuromuscular electrostimulation device, offers an alternative method of thromboprophylaxis for patients who cannot be prescribed other modes of VTE prevention, like pharmacological intervention. Already adopted in parts of the Middle East and other international healthcare systems, the device works by stimulating the common peroneal nerve to increase blood flow in the deep veins of the calf. The increased blood flow is clinically proven to increase blood flow up to 60% of walking and preventing clotting.
Such innovation can provide healthcare systems around the world with a safe and cost-effective thromboprophylactic alternative for patients who cannot adhere to current methods of VTE prevention and have the potential to help standardise the delivery of care by healthcare professionals.
Driving better healthcare
The introduction of MedTech into the VTE prevention care pathway in the Middle East could help solve some of the leading issues associated with the condition in the region. Despite various strategies to minimise the gap between standardisation of care, innovation poses an attractive proposition that can drive up patient adherence, contributing to lives saved and healthcare costs reduced.
Further and more up to date research is required on VTE management in the Middle East to better understand the true impact of the condition and where clinically proven MedTech can play a role. The more healthcare systems wish to embrace innovation to address the widespread risk and unmet need for VTE prevention, the more opportunities they will have to unlock positive patient outcomes and standardise care.