Venous thromboembolism (VTE) — also known as deep vein thrombosis (DVT) — is a significant and global health issue with rising prevalence in the Middle East, particularly Saudi Arabia. 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 of deep vein thrombosis
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 the 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 per cent of Saudi Arabians were aware of DVT. What’s more, a 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 Saudi Arabia, with significant variability in the implementation of thromboprophylaxis methods in the nation’s hospitals.
Moreover, a Middle Eastern (AVAIL ME) study of more than 2,000 patients — with 200 from a hospital in Saudi Arabia — found that patient compliance to VTE guideline-based thromboprophylaxis was as low as 40.1 per cent in medical patients and 36.4 per cent in surgical patients, indicating a large unmet need for at-risk patients across the region.
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Understanding the risks of VTE
Currently in Saudi Arabia, 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 hospitals in Saudi Arabia — and the wider world — 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 Middle East 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 per cent of walking and preventing clotting.
Such innovations can provide healthcare systems in Saudi Arabia 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.
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Driving better healthcare
The introduction of medtech into the VTE prevention care pathway in Saudi Arabia 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 research is required on VTE management in Saudi Arabia 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.
References available on request.
Bernard Ross is the CEO of Sky Medical Technology.
