Rosovsky Rachel, Merli Geno
Department of Medicine, Division of Hematology and Oncology, Massachusetts General Hospital, Boston, MA.
Department of Surgery and Medicine, Jefferson Vascular Center, Thomas Jefferson University Hospitals, Philadelphia, PA.
Tech Vasc Interv Radiol. 2017 Sep;20(3):141-151. doi: 10.1053/j.tvir.2017.07.003. Epub 2017 Jul 5.
The emergence of direct oral anticoagulants (DOACs) represents a major advancement and paradigm shift in the treatment of venous thromboembolism. Currently, dabigatran, rivaroxaban, apixiban, and edoxoban are approved and used routinely for the prevention and treatment of patients with venous thromboembolism. Because each of the DOACs has different doses and dosing regimens, clinicians need to become familiar with their use. This article focuses on the practical considerations of how and when to use the DOACs. It also aims to explore follow-up monitoring, use in special populations, reversal agents, periprocedural management, and how to handle bleeding complications with the DOACs.
直接口服抗凝剂(DOACs)的出现代表了静脉血栓栓塞治疗领域的一项重大进展和范式转变。目前,达比加群、利伐沙班、阿哌沙班和依度沙班已被批准并常规用于静脉血栓栓塞患者的预防和治疗。由于每种DOAC的剂量和给药方案不同,临床医生需要熟悉它们的使用方法。本文重点关注如何以及何时使用DOACs的实际考量因素。它还旨在探讨随访监测、特殊人群中的使用、逆转剂、围手术期管理以及如何处理DOACs相关的出血并发症。