Cleveland Clinic's Thrombosis Center is a multidisciplinary specialty treatment group dedicated to the diagnosis and treatment of hypercoagulable conditions or thrombophilia.
The Thrombosis Center brings together clinicians that specialize in blood clotting disorders. The team includes physicians and nurses from Cardiovascular Medicine (Cardiology and Vascular Medicine), the Cancer Institute (Hematology), Laboratory Medicine, Pediatrics, Genetics, Internal Medicine, Interventional Radiology, Cardiovascular and Vascular Surgery, Cardiovascular Anesthesiology, Interventional Radiology and the Lerner Research Institute.
These individuals possess expertise in genetic and diagnostic testing, medical management or surgical and interventional or endovascular procedures for patients with the genetic (hereditary) and acquired conditions that the center specializes in.
What We Treat
Cleveland Clinic's Thrombosis Center is dedicated to diagnosing and treating conditions related to thrombosis, often called hypercoagulable conditions, thrombophilia or blood clotting disorders. People with these conditions have an increased risk for developing blood clots in the veins (blood vessels that carry blood to the heart) and less often in the arteries (blood vessels that carry blood away from the heart). A clot inside a blood vessel is also called a thrombus or an embolus. Thrombophilia or hypercoagulable conditions are generally due to several factors but may be genetic (inherited) or acquired (following surgery, trauma, hospitalization, medical disease or even related to medications).
These conditions can be dangerous, especially when they are not identified and treated properly. Blood clots increase the risk for death from a pulmonary embolism, stroke or a heart attack. They can also lead to other complications including severe leg pain and/or swelling, difficulty walking, or even the loss of a limb.
Genetic or Hereditary Conditions
- Factor V Leiden (the most common known hereditary condition)
- Prothrombin gene mutation (G20210A)
- Deficiencies of natural proteins that prevent clotting called anticoagulant proteins - such as antithrombin (formerly antithrombin III), protein C and protein S
- Abnormal fibrinolytic system, (that which breaks down blood clots after they have formed) including hypoplasminogenia, dysplasminogenia, and elevation in levels of Plasminogen activator inhibitor or PAI-1
- Elevated levels of factor VIII as well as elevation of factors II, VIIa, IX, XI, and XII
- Elevated homocysteine levels and the common genetic variant methylene tetrahydrofolate reductase (MTHFR)
- Elevated levels of fibrinogen
- Elevated levels of lipoprotein (a), a type of cholesterol
- Platelet disorders
- Heparin-induced thrombocytopenia (an abnormal immune reaction to heparin or any of the low molecular weight heparin preparations)
- Antiphospolipid (antibody) syndrome
- Myeloproliferative disorders such as polycythemia vera or essential thrombocytosis
- Cancer or cancer treatment including specific chemotherapy medications
- Pregnancy, oral contraceptives or hormone replacement therapy (HRT)
- Thrombotic thrombocytopenia purpura (TTP)
- Paroxysmal nocturnal hemoglobinuria (PNH)
- Disseminated intravascular coagulation (DIC)
- Nephrotic syndrome
- Inflammatory bowel disease (IBD)
- Behcet's syndrome
- Thromboangiitis obliterans (Buerger' disease)
- Previous history of deep vein thrombosis (DVT) or pulmonary embolism (PE)
- Post surgery or trauma
- Economy Class Syndrome
- Prolonged immobility
Why choose Cleveland Clinic for your care?
Our outcomes speak for themselves. Please review our facts and figures and if you have any questions don't hesitate to ask.
Our vascular specialists and surgeons are world-renowned leaders in the treatment of blood clotting disorders. Each year we see more than 6,000 patients in the Thrombosis Center.
Our Medical Team
- John Bartholomew, MD - Co-Director, Thrombosis Center; Joint Appointment, Hematologic Oncology and Blood Disorders
- Marcelo Gomes, MD Co-Director, Thrombosis Center
- Kandice Kottke-Marchant, MD, PhD - Assistant Director, Thrombosis Center Department of Laboratory Medicine and Pathology
Cardiovascular Medicine, Section of Vascular Medicine
This group of specialized physicians will evaluate you and begin to develop your plan of care. They are all specialized to perform diagnostic testing and treat patients with clotting disorders and vascular disease.
- John Bartholomew, MD
- Natalie Evans, MD
- Natalia Fendrikova-Mahlay
- Marcelo Gomes, MD
- Deborah Hornacek, MD
- Douglas Joseph, DO
- Meghann McCarthy, DO
Cardiovascular Medicine, Section of Heart Failure
Heart failure specialists are consulted when the hematologic condition is related to poor pumping ability of the heart.
Cardiothoracic and Vascular Surgery
Surgical procedures for thrombosis are sometimes needed to treat blood clots or treat conditions related to clot formation.
Taussig Cancer Institute
Hematologic Oncology and Blood Disorders
Hematologists are specialized physicians that diagnose and treat disorders related to the blood and work closely with the Vascular Medicine physicians to ensure a complete plan of care.
Other specialties are often needed to assist in confirming a diagnosis or treating an underlying or associated condition. These medical professionals are experts in their field and have a particular specialty interest in the treatment of thrombosis and hemostasis conditions.
Center for Personalized Genetic Healthcare Genomic Medicine Institute
- Patty Arscott, Genetic Counselor
- Gina Keeler, Clinical Manager
Tomsich Pathology Laboratories
- Michael Militello, PharmD, RPh, BCPS
Toll-free 800.223.2273, ext. 44420 for evaluations.
Let the appointment office know if you are having acute or urgent symptoms.
When you make your appointment, ask the administrative assistant for the name of your physician and desk number. You will be told to go to Desk J3 - 5 in the Heart & Vascular Institute or Desk R35 in the Taussig Cancer Center, 9500 Euclid Avenue, Cleveland, OH.
Use our secure online form to submit an appointment request 24/7. We will receive it and follow-up with you as soon as possible.
Mon. - Fri., 8 a.m. - 5 p.m. (ET):
Toll-free 800.223.2273, ext. 44420, or call the physician's office directly.
What to Expect
Whether you are coming from around the corner or around the world, you want to know what to expect before, during and after your visit with us. If you have any questions while reviewing this information, please contact us. We are happy to answer any questions you may have.
Before your appointment
If you are scheduled at least one week away, you will be asked to send in your records, including medical history, test results and films (such as echocardiogram, ultrasound, chest x-ray, MRI or CT as applicable). All information should be sent in the same package (clearly marked with your name and address) via Airborne Express, Federal Express, or certified U.S. mail (make sure you have a tracking number) to the physician with which you have an appointment. Thrombosis Center patients may be directed to Vascular Medicine or Taussig Cancer Institute depending on your underlying condition. The address to mail your records is:
For Vascular Medicine:
Vascular Medicine – Desk J3 - 5
9500 Euclid Avenue
Cleveland, OH 44195
For Taussig Cancer Institute:
Taussig Cancer Institute – Desk R35
9500 Euclid Avenue
Cleveland, OH 44195
If you are scheduled less than one week out, please bring your records to your appointment.
Traveling to Cleveland Clinic
When you make your appointment, we would like to make traveling to Cleveland Clinic as easy as possible. Information on travel to the Miller Family Heart & Vascular Institute or Taussig Cancer Institute.
During your appointment
Please note: Parking for your appointment will vary whether you are at Taussig or the Miller Family Heart & Vascular Institute.
After your visit
You will initially meet with either a nurse clinician, resident. or fellow who will review your information and begin the documentation process. The diagnosis and treatment of blood clotting disorders involves three main areas:
- Thorough history and physical examination
- Comprehensive laboratory testing
- Patient management and recommendations
Depending on the specific type of blood clotting disorder, you may be sent for specialized blood tests and imaging tests. Cleveland Clinic's Tomsich Pathology Laboratories offers an extensive range of diagnostic laboratory tests. Results and recommendations are discussed with your doctor by experts in vascular medicine, hematology, and laboratory medicine.
You will then meet with your Center physician who will review your records and take a medical history, perform a physical exam, and advise on consultations with other specialists within the Center as needed. If you need to meet with one of the multidisciplinary specialists, you will see the specialist within 1 to 2 days. The Thrombosis Center physician will provide you with a diagnosis and plan of care.
The Thrombosis Center physicians and/or Geneticists are also available to evaluate family members who are at risk for genetic or hereditary blood clotting disorders.
How long will you need to stay at Cleveland Clinic?
To complete all testing, you will need to stay in the Cleveland area for 1 to 2 days.
- There are about 300,000-600,000 cases of pulmonary embolism (PE) each year.
- PE is the third leading cause of cardiovascular death
- Hospital patients are at high risk for development of both Deep Vein Thrombosis (DVT) and PE. Death from PE can be reduced by prompt recognition of signs and symptoms of PE, early diagnosis and quick initiation of treatment.
Pulmonary Embolism Response Team (PERT)
In order to improve the care and outcomes of patients who come to the hospital with the symptoms of PE or develop PE while hospitalized, the Cleveland Clinic developed a multidisciplinary Pulmonary Embolism Response Team (PERT). The purpose of the PERT team is to:
- Streamline the care of patients
- Coordinate real-time consultation by a multidisciplinary team
- Ability to rapidly
- Make complex therapeutic decisions
- Mobilize necessary resources
- Provide effective treatment
Members include experts from vascular medicine, cardiothoracic surgery, interventional radiology, chest radiology, internal medicine, hematology, emergency room medicine, cardiology and pulmonary critical care.
Due to standardized guidelines, the PERT team is able to risk strategy and treat patients in less than 30 minutes from time of notification.
Horlander KT, Mannino DM, Leeper, KV, Pulmonary embolism mortality in the United States, 1979-1998:
an analysis using multiple-cause mortality data. Arch Intern Med. 2003; 163(14):1711-7 (ISSN: 0003-
9926). Accessed 4/2018
American Heart Association Statistics Committee and Stroke Statistics SubcommitteeHeart Disease and
Stroke Statistics—2015 Update. Circulation. 2015;131:e29-e322 Accessed 4/2018
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