Kido K, Noyes E, Gutnik L
Department of Pharmacy Practice, South Dakota State University, Sioux Falls, SD, USA.
Department of Pharmacy Service, Avera McKennan Hospital, Sioux Falls, SD, USA.
J Clin Pharm Ther. 2017 Oct;42(5):631-633. doi: 10.1111/jcpt.12552. Epub 2017 May 11.
There is a lack of consensus regarding optimal anticoagulation regimen and duration for inferior vena cava (IVC) thrombus due to the paucity of clinical evidence. A case of IVC thrombus treated with 3 months of rivaroxaban therapy is reported.
Fifty-two-year-old male Caucasian presented following a motorcycle accident, with multiple left rib fractures requiring emergent amputation surgeries. During the hospitalization, he developed IVC thrombosis and completed 3 months of rivaroxaban treatment without any complication. The Doppler images at 6-week, 3-month and 6-month follow-up appointments showed no IVC thrombosis.
This is the first case of IVC thrombosis successfully treated with rivaroxaban. Further case series and clinical studies are needed to guide the use of direct oral anticoagulants for IVC thrombosis.
由于临床证据匮乏,对于下腔静脉(IVC)血栓形成的最佳抗凝方案和持续时间尚无共识。本文报告了1例接受利伐沙班治疗3个月的IVC血栓病例。
一名52岁的白种男性在摩托车事故后就诊,因多处左侧肋骨骨折需要紧急截肢手术。住院期间,他发生了IVC血栓形成,并完成了3个月的利伐沙班治疗,未出现任何并发症。在6周、3个月和6个月随访时的多普勒图像显示无IVC血栓形成。
这是首例成功使用利伐沙班治疗IVC血栓形成的病例。需要进一步的病例系列研究和临床研究来指导直接口服抗凝剂在IVC血栓形成治疗中的应用。