Montiel Francisco Sánchez, Ghazvinian Raein, Gottsäter Anders, Elf Johan
Department of Vascular Diseases, Lund University, Skåne University Hospital, S-205 02 Malmö, Sweden.
Thromb J. 2017 Oct 3;15:26. doi: 10.1186/s12959-017-0149-x. eCollection 2017.
Upper extremity deep vein thrombosis (UEDVT) constitutes around 10% of all DVT, and can cause both pulmonary embolism (PE) and postthrombotic syndrome (PTS) in the arm. The incidence of secondary UEDVT is increasing due to widespread use of central venous catheters in patients with cancer and other chronic diseases. The safety and efficacy of using new direct acting oral anti coagulants (DOAC) in the treatment of UEDVT has not been systematically evaluated. Our aims were to evaulate efficacy, safety, and risk of recurrence of venous thromboembolism (VTE) during DOAC treatment in UEDVT patients.
Data from the Swedish national anticoagulation registry (AuriculA) was retrospectively evaluated for all 55 patients (27 men aged 23-86 years, and 28 women aged 18-75 years) treated with DOAC because of UEDVT between 2012 and 2015 in the southernmost hospital region of Sweden with 1.3 million inhabitants in 2016. Patients were followed for 6 months.
During 6 months after institution of DOAC treatment there was one recurrence (2%) of DVT during treatment and two (4%) recurrences after cessation of treatment. No patient died, whereas one (2%) suffered a clinically relevant nonmajor bleeding.
DOAC can be used in the treatment of UEDVT patients with acceptable efficacy and safety.
上肢深静脉血栓形成（UEDVT）约占所有深静脉血栓形成（DVT）的10%，可导致手臂发生肺栓塞（PE）和血栓形成后综合征（PTS）。由于癌症和其他慢性病患者广泛使用中心静脉导管，继发性UEDVT的发病率正在上升。新型直接口服抗凝剂（DOAC）用于治疗UEDVT的安全性和有效性尚未得到系统评估。我们的目的是评估DOAC治疗UEDVT患者期间静脉血栓栓塞（VTE）的疗效、安全性和复发风险。
回顾性评估瑞典国家抗凝注册中心（AuriculA）的数据，该数据来自2012年至2015年期间在瑞典最南端医院地区因UEDVT接受DOAC治疗的所有55例患者（27例男性，年龄23 - 86岁，28例女性，年龄18 - 75岁），该地区在2016年有130万居民。对患者进行了6个月的随访。
在开始DOAC治疗后的6个月内，治疗期间有1例（2%）DVT复发，停药后有2例（4%）复发。无患者死亡，而有1例（2%）发生了临床相关的非大出血。
DOAC可用于治疗UEDVT患者，疗效和安全性可接受。
