Rivaroxaban or vitamin-K antagonists following early endovascular thrombus removal and stent placement for acute iliofemoral deep vein thrombosis.
Thromb Res
; 172: 86-93, 2018 12.
Article
em En
| MEDLINE
| ID: mdl-30391776
ABSTRACT
BACKGROUND:
The optimal anticoagulant following catheter-based therapy of acute iliofemoral deep vein thrombosis (IFDVT) is unknown.METHODS:
From the Swiss Venous Stent registry, an ongoing prospective cohort study, we performed a subgroup analysis of patients with acute IFDVT who underwent catheter-based early thrombus removal followed by nitinol stent placement. Duplex ultrasound and Villalta scores were used to determine patency rates and incidence of the post-thrombotic syndrome (PTS) in patients treated with either rivaroxaban (nâ¯=â¯73) or a vitamin K-antagonist (VKA; nâ¯=â¯38) for a minimum duration of 3â¯months.RESULTS:
Mean follow-up duration was 24⯱â¯19â¯months (range 3 to 77â¯months). Anticoagulation therapy was time-limited (3 to 12â¯months) in 56% of patients (47% in the rivaroxaban group and 58% in the VKA group, pâ¯=â¯0.26), with shorter mean duration of anticoagulation in the rivaroxaban group (180⯱â¯98â¯days versus 284⯱â¯199â¯days, pâ¯=â¯0.01). Overall, primary and secondary patency rates at 24â¯months were 82% (95%CI, 71-89%) and 95% (95%CI, 87-98%), respectively, with no difference between the rivaroxaban (87% [95%CI, 76-94%] and 95% [95%CI, 85-98%]) and the VKA group (72% [95%CI, 52-86%] and 94% [95%CI, 78-99%]; pâ¯>â¯0.10 for both). Overall, 86 (86%) patients were free from PTS at latest follow-up, with no difference between the rivaroxaban and the VKA groups (57 [85%] versus 29 [88%]; pâ¯=â¯0.76). Two major bleeding complications (1 in each group) occurred in the peri-interventional period, without any major bleeding thereafter.CONCLUSIONS:
In patients with acute IFDVT treated with catheter-based early thrombus removal and venous stent placement, the effectiveness and safety of rivaroxaban and VKA appear to be similar. CLINICAL TRIAL REGISTRATION The study is registered on the National Institutes of Health website (ClinicalTrials.gov; identifier NCT02433054).Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Vitamina K
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Terapia Trombolítica
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Trombose Venosa
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Síndrome Pós-Trombótica
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Procedimentos Endovasculares
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Rivaroxabana
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Anticoagulantes
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Thromb Res
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Suíça