Ask Dr. Stephan Moll

These questions have been submitted by folks on the mailing list and answered by Dr. Moll, Director of the Thrombophilia Program at the Carolina Cardiovascular Biology Center, Department of Medicine, Division of Hematology-Oncology, UNC Chapel Hill (North Carolina, USA). Why am I doing this?

62. Alternative medicine - PlasminPlus

Q: "I had a pulmonary embolism and deep vein thrombosis last year. I got them driving non-stop 21+ hours from N.Y. to Florida a few times. I had a Greenfield filter installed and my pulmonologist suggested I take coumadin® for life. But since I have no family history of clots and all blood tests for clotting abnormalities have tested negative I disagree with that. Have you heard of the alternative from China called PlasminPlus? You can read extensively about it at this link. [They] claim is that it has no side effects and is totally natural. Please let me know your opinion about it.

A: I had not heard of PlasminPlus before. I reviewed the description on the webpage mentioned above; the website does not provide any scientific information or references, just some non-descript pseudoscientific talk. Nothing on PlasminPlus has been published in peer-reviewed journals. My opinion: I would not take PlasminPlus and would advise patients not to take it.

Regarding the patient above: For full assessment several other details about his/her DVT and PE are needed (How extensive were the DVT and PE? Why was a Greenfield filter placed? Does he/she still have a lot of symptoms of shortness of breath or leg pain and swelling? Does a repeat Doppler ultrasound show remaining clot in the legs?). I often recommend long-term warfarin (coumadin) in patients with IVC filters (also see Q/A 4). If a patient with IVC filter is doing well and has no remaining clot in the legs, I discuss the risk and benefit of long-term warfarin with the patient. We then sometimes decide to stop the warfarin. If the patient above did not have a Greenfield filter one could make a good argument for not continuing warfarin, since his/her DVT and PE were triggered by a transient risk factor, the long car ride. The risk of recurrent clot, while off warfarin, would likely be low, if he/she took frequent breaks during future long-distance car rides.

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