Rivaroxaban versus Warfarin in the Management of Deep Venous Thrombosis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mahmoud Shawky El-metieni ◽  
Tamer Mohamed Fekry ◽  
Mohammed Ahmed Hassan Rady ◽  
Ahmed Magdy Farrag ◽  
Ahmed Mohamed Ismail
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Randomized Study ◽  
Duplex Ultrasound ◽  
Lower Limbs ◽  
P Value ◽  
Vein Thrombosis ◽  
Warfarin Group ◽  
Blood Clots ◽  
Study Population

Abstract Background Deep venous thrombosis (DVT) refers to the formation of one or more blood clots in one of the body’s large veins, most commonly in the lower limbs. The clot can cause partial or complete blocking of circulation in the vein, which in some patients leads to pain, swelling, tenderness, discolouration of the skin that is warm to touch. Aim of the Work Compare the effect of direct Oral Anticoagulant (Rivaroxaban) versus Antivitamin K (warfarin) in treatment of lower limb Deep Venous Thrombosis. Patients and Methods Type of study: prospective single blinded randomized study, study setting: was conducted at Kobri Elkobba hospitals, study period: 6 months, study population: Eligible all patients above 18 years had femoropopliteal vein thrombosis, confirmed with duplex ultrasound scanning and D-dimer test and qualified under the inclusion and exclusion criteria of the study. Results Our study shows that Rivaroxaban alone is as effective as standard therapy, with similar safety, for the treatment of acute DVT and in preventing recurrence and has low risk of bleeding. There was statistically significant increase in INR monitoring during 6 months in warfarin group than Rivaroxaban group with p-value < 0.001. This because warfarin has many drug and food interaction. There's no response in treatment out come after 3 months duplex as the study was on patient of femoro popliteal DVT, however there were clinical improvement in both groups. Complete recanalization with normal augmentation by muscle compression occurred in all Rivaroxaban patients compared to 5% were partially compressible with incomplete recanalization in warfarin group after 6 months of treatment. Conclusion We concluded in patients with unprovoked VTE, rivaroxaban has the potential to reduce both the risk of major bleeding and recurrent VTE compared to warfarin. And there’s no need for adjusting the dose and INR monitoring, and Rivaroxaban has no food nor drug interactions.

Double-Blind, Randomized Comparison of Systemic Continuous Infusion of 0.25 Versus 0.50 mg/kg/24 h of Alteplase over 3 to 7 Days for Treatment of Deep Venous Thrombosis in Heparinized Patients: Results of the European Thrombolysis with rt-PA in Venous Thrombosis (ETTT) Trial

1992 ◽  
Vol 67 (03) ◽  
pp. 306-309 ◽  
Author(s):  
H Bounameaux ◽  
J D Banga ◽  
E Bluhmki ◽  
S Coccheri ◽  
J N Fiessinger ◽  
...  
Keyword(s):  
Treatment Group ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Continuous Infusion ◽  
Dosage Regimen ◽  
Lower Limbs ◽  
Double Blind ◽  
Vein Thrombosis ◽  
Group I ◽  
Group Ii

SummaryThirty-two patients with acute, proximal-vein thrombosis were treated with heparin and alteplase (0.25 versus 0.5 mg/kg/24 h during 3-7 days) in a randomized, double-blind, multicenter, European (ETTT) trial. The treatment resulted in a decrease of the venographic Marder’s score from 18 (6-25) to 13 (2-24) units (median, range) in Group I (0.25 mg/kg/24 h, n = 15, median decrease 3.0, p = 0.32) and from 17.5 (3-33) to 15.5 (0-27) in Group II (0.5 mg/kg/24 h, n = 16, median decrease 4.0, p = 0.23). Comparison of the sequential venograms could be performed in 14 cases of Group I and in 15 cases in Group II. A minority of patients showed substantial partial recanalization of the initially obstructed veins on the control venogram (one in each treatment group) and most of the control venograms showedThus, the results of the ETTT trial show that the used low dosages of alteplase administered intravenously over 3-7 days in heparinized patients cannot be recommended as a treatment for patients with deep venous thrombosis of lower limbs and/or pelvis. Further studies are needed to define a more suitable dosage regimen of alteplase in this indication.

Deep Vein Thrombosis Post Radiofrequency Ablation of the Saphenous and Perforator Veins: Is Duplex Ultrasound Necessary within Five Days?

2017 ◽  
Vol 41 (1) ◽  
pp. 11-12
Author(s):  
Anita Altawan ◽  
David Golchian ◽  
Mazen Bazzi ◽  
John Iljas ◽  
Bipinchandra Patel
Keyword(s):  
Deep Vein Thrombosis ◽  
Radiofrequency Ablation ◽  
Venous Thrombosis ◽  
Radio Frequency ◽  
Deep Venous Thrombosis ◽  
Venous Insufficiency ◽  
Duplex Ultrasound ◽  
Vein Thrombosis ◽  
Post Procedure ◽  
Deep Vein

Radiofrequency ablation (RFA) of the saphenous and perforator veins (“closure”) is a relatively newer option for treatment of venous insufficiency patients. A known complication of the RFA is deep vein thrombosis also known as DVT. The purpose of this study is to demonstrate the probability of acute deep venous thrombosis post radio-frequency vein ablation. This research also helped determine medical necessity of a postoperative venous duplex examination within 5 days post-procedure.

Prevalence of asymptomatic lower limb venous thrombosis in infertile women with thrombophilic disorders

2014 ◽  
Vol 30 (7) ◽  
pp. 449-454
Author(s):  
Luca Costanzo ◽  
Luigi Di Pino ◽  
Mario Ragusa ◽  
Sergio Buccheri ◽  
Andrea Sole ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Prognostic Value ◽  
Duplex Ultrasound ◽  
Lower Limbs ◽  
Control Group ◽  
Infertile Women ◽  
Vein Thrombosis ◽  
Venous Circulation ◽  
High Prevalence ◽  
Deep Vein

Objective We sought to assess the prevalence of asymptomatic venous thrombosis in infertile women with thrombophilic disorders (TDs). Methods and results A total of 73 infertile women with TDs underwent duplex ultrasound scan to evaluate superficial and deep venous circulation of lower limbs. A control group of 35 infertile women without TDs was included. A single TD was found in 13 (17.8%) subjects, and 40 (54.8%) women presented a combined defect (more than three alterations). No residual mural thrombosis (RT) was noted in any deep veins. We found RT in 48 (65.8%) patients of TD group, while no RT was found in the control group ( p < 0.0001). None of the clinical and prothrombotic factors were predictors of RT (all p > 0.20), and frequency of TD did not correlate with multi-vessel RT ( p = 0.252). Conclusions No signs of deep vein thrombosis but high prevalence of superficial RT is present in infertile women with TDs. Further studies are needed to assess the prognostic value of our findings.

The Phlebographic Distribution of Deep Venous Thrombosis in the Calf and its Relevance to Duplex Ultrasound

1992 ◽  
Vol 7 (2) ◽  
pp. 64-66 ◽  
Author(s):  
M. Lea Thomas ◽  
G. Solis
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Outcome Measures ◽  
Duplex Ultrasound ◽  
Popliteal Vein ◽  
Detailed Knowledge ◽  
Vein Thrombosis ◽  
Deep Vein

Objective: To assess the distribution of deep vein thrombosis in the calf by phlebography. Setting: Department of Vascular Radiology, St. Thomas' Hospital, London, England. Patients: Seventy patients with suspected deep vein thrombosis or pulmonary embolism were examined. Interventions: Bilateral ascending contrast phlebography was performed in all patients. Main Outcome Measures: The sites of any thrombus in the stem or muscle veins of the calf below the popliteal vein were recorded. Results: One hundred legs contained thrombus. In fifty-three legs thrombus was present solely in the calf veins below the popliteal vein. Isolated thrombus in either one or more of the three paired stem veins or the muscle veins was present in twenty-two calves. Conclusions: Because of the difficulty in visualising some calf veins by duplex ultrasound it is suggested that a detailed knowledge of the distribution of thrombus may assist ultrasonographers.

DEEP VEIN THROMBOSIS PROPHYLAXIS IN SURGICALLY TREATED FRACTURED HIP PATIENTS

1987 ◽  
Author(s):  
P J Powers ◽  
M Gent ◽  
R Jay ◽  
J Hirsh ◽  
M Levine ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Placebo Group ◽  
Venous Thrombosis ◽  
Major Complication ◽  
Lower Limbs ◽  
Thrombosis Prophylaxis ◽  
Double Blind ◽  
Vein Thrombosis ◽  
Warfarin Group ◽  
Deep Vein

Deep vein thrombosis is a major complication in'patients treated surgically for fractured hip. Methods employed toreduce the risk of thrombosis include dextran, ASA, warfarin, low or adjusted dose heparin and calf compression, but none has widespread acceptance.A randomized trial wascarried out to assess the effectiveness of sodium warfarinand acetyl salicylic acid(aspirin) compared to placebo inthe prevention of venous thrombosis in fractured hip patients. One hundred and ninty four patients were randomizedto receive warfarin (65 patients), ASA (66 patients) or placebo (63 patients).Prophylaxis commenced post operatively and continued for 21 days or until discharge, if earlier.Warfarin patients received 10 mg sodium warfarin orally as soon as possible after surgery. Warfarin was then given daily according to the prothrombin time (PT), to obtain a PT of 16 seconds on the 5th post operative day. The PT was maintain at 16 to 18 seconds until the end of treatment.ASA and placebo patients received enteric coated tablets, 650 mg twice daily, in a double blind fashion beginning as soon as possible post operatively and continuingto the end of treatment. Surveillance testing and I-fibrinogen leg scanning and impedance plethysmography was performed and venography was done if either test suggested thrombus at the popliteal vein or above. Otherwise venography was performed at day 21 or prior to discharge, if earlier. Venous thrombosis occurred in 13 patients (20%) in the warfarin group, 27 patients (^0.9%) in the ASA group, and 29 patients (46%) in the placebo group (P=0.005). Proximal vein thrombosis or pulmonary embolism occurred in 6patients (9.2%) in the warfarin group,7 patients (10.6%) in the ASA and 19 patients (30.2%) in the placebo group (P=0.002). Two major hemorrhages occurred in the warfarin group, none in the ASA group, and 2 in the placebo group.The results of this study show sodium warfarin to be safeand effective in reducing thromboembolic complications infractured hip patients and ASA to be effective in reducing thrombosis involving the proximal deep veins of the lower limbs in these patients.

scholarly journals Clinical and etiological profile of unprovoked thrombosis in young patients admitted at a tertiary care hospital

2017 ◽  
Vol 5 (10) ◽  
pp. 4595
Author(s):  
Nadeem Ahmad ◽  
Nihida Akhter ◽  
Tufail Ahmad Sheikh
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Factor V Leiden ◽  
Janus Kinase ◽  
Lower Limbs ◽  
Cerebellar Infarction ◽  
Factor V ◽  
Care Hospital ◽  
Factor V Leiden Mutation ◽  
Vein Thrombosis

Background: It is now possible to identify acquired and hereditary risk factors in a substantial percentage of patients presenting with a venous thrombotic event. The objective of the study was to study the clinical and etiological profile of patients with unprovoked thrombosis in young patients.Methods: Twenty-one patients 09 males (42.8%) and 12 females (57.14%) with a mean age of 29.67±5.21 were studied, who presented with unprovoked thrombosis.Results: Among 21 patients studied most common presentation was deep venous thrombosis of lower limbs (38.09%) followed by recurrent abortions with deep venous thrombosis (14.28%) and cerebellar infarction (14.28%). In etiological profile, the most common thrombophilla was factor V Leiden mutation (28.57%) followed by antiphospholipid antibody syndrome (23.8%), protein C deficiency (19.04%), methylene tetrahydrofolate reductase (9.52%) and antithrombin, prothrombin gene mutation, hyperhomocystenemia and janus kinase 2 mutations (4.76%). Among 6 patients of factor V Leiden mutation 3 presented with deep venous thrombosis of lower limbs, 1 patient each with middle cerebral artery infarct, juglar vein thrombosis and subclavian vein thrombosis respectively.Conclusions: Factor V Leiden mutation is the most common inherited thrombophillias which has been "substantiated from various studies.

Proximal deep venous thrombosis following PTA of the superficial femoral artery – an obligation to disclose a complication that is rarely taken into account

VASA ◽  
2006 ◽  
Vol 35 (1) ◽  
pp. 41-44 ◽  
Author(s):  
Klein-Weigel ◽  
Pillokat ◽  
Klemens ◽  
Köning ◽  
Wolbergs ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Rare Complication ◽  
Femoral Vein ◽  
Vein Thrombosis ◽  
Explicit Information ◽  
Life Threatening ◽  
Legal Consequences

We report two cases of femoral vein thrombosis after arterial PTA and subsequent pressure stasis. We discuss the legal consequences of these complications for information policies. Because venous thrombembolism following an arterial PTA might cause serious sequel or life threatening complications, there is a clear obligation for explicit information of the patients about this rare complication.

Outcome of Anticoagulation in Isolated Distal Deep Vein Thrombosis Compared to Proximal Deep Venous Thrombosis

2021 ◽  
Author(s):  
Danielle T Vlazny ◽  
Ahmed K Pasha ◽  
Wiktoria Kuczmik ◽  
Waldemar E Wysokinski ◽  
Matthew Bartlett ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Vein Thrombosis ◽  
Distal Deep Vein Thrombosis ◽  
Deep Vein

scholarly journals Topical vs. intravenous administration of tranexamic acid in knee arthroplasty and prevalence of deep venous thrombosis: a randomized clinical trial

2016 ◽  
Vol 15 (2) ◽  
pp. 120-125 ◽  
Author(s):  
Ari Zekcer ◽  
Ricardo Del Priori ◽  
Clauber Tieppo ◽  
Ricardo Soares da Silva ◽  
Nilson Roberto Severino
Keyword(s):  
Total Knee Arthroplasty ◽  
Tranexamic Acid ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Intravenous Administration ◽  
Knee Arthroplasty ◽  
Duplex Ultrasound ◽  
Control Group ◽  
Perioperative Bleeding ◽  
Total Knee

Abstract Background Tranexamic acid (TXA) is widely used in orthopedic surgery to reduce perioperative bleeding. Since TXA inhibits fibrinolysis, there is concern that it may increase the risk of thromboembolic events. Objectives To verify the prevalence of deep venous thrombosis (DVT) in patients receiving TXA during total knee arthroplasty and to compare topical with intravenous administration of the drug. Methods All patients admitted for total knee arthroplasty due to primary arthrosis between June and November of 2014 were recruited consecutively. Thirty patients were randomized to a “topical group” (1.5 g TXA diluted in 50ml saline sprayed over the area operated, before tourniquet release), 30 to an “intravenous group” (20mg/kg TXA in 100 ml of saline, given at the same time as anesthesia), and 30 to a control group (100 ml of saline, given at the same time as anesthesia). All patients had duplex ultrasound scans of the legs on the 15th postoperative day. Results Deep venous thrombosis events occurred in five of the 90 patients operated (one out of 30 in the topical group [3.3%], four out of 30 in the control group [13.3%], and zero in the intravenous group). All were confirmed by duplex ultrasound scans and all were asymptomatic. Prevalence rates of DVT were similar between groups (p = 0.112 for control vs. intravenous; p = 0.353 for control vs. topical; and p =1.000 for intravenous vs. topical, according to two-sided exact tests). Conclusions Both topical and intravenous administration of TXA are safe with regard to occurrence of DVT, since the number of DVT cases in patients given TXA was not different to the number in those given placebo.

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