University of Florida Health Jacksonville, University of Florida, 655 W 8th Street, C-89, Jacksonville, FL, 32209, USA.
J Thromb Thrombolysis. 2018 Jul;46(1):58-61. doi: 10.1007/s11239-018-1682-6.
Ultrasound-assisted catheter-directed thrombolysis (USAT) is a novel approach for the treatment of venous thromboembolism (VTE) that is thought to be associated with a decreased risk of bleeding. Direct oral anticoagulants (DOACs) are approved for the treatment of VTE but have not been studied in a post-fibrinolysis setting. The intention of this retrospective observational study was to determine the safety and effectiveness of DOACs compared to the vitamin-K-antagonist (VKA) warfarin following USAT in patients with documented VTE. Included patients were aged 18 years or older who had documented VTE and received oral anticoagulation with either a DOAC or VKA following USAT. The primary outcome of this study was to compare the 90-day composite incidence of major and minor bleeding and recurrent VTE between patients receiving DOACs after USAT to those receiving VKA after USAT. Similar rates of bleeding and recurrent VTE were observed (4/42; 9.5% in the DOAC group versus 2/34; 5.9% in the VKA group). The use of DOAC therapy post-USAT for VTE was not associated with higher rates of 90-day major or minor bleeding or 90-day recurrent VTE.
超声辅助导管溶栓术（USAT）是一种治疗静脉血栓栓塞症（VTE）的新方法，据认为其出血风险较低。直接口服抗凝剂（DOACs）已被批准用于治疗 VTE，但尚未在溶栓后进行研究。本回顾性观察研究的目的是确定 DOACs 与维生素 K 拮抗剂（VKA）华法林在 USAT 后治疗有记录的 VTE 患者的安全性和有效性。本研究纳入的患者年龄在 18 岁或以上，有记录的 VTE，并在 USAT 后接受 DOAC 或 VKA 口服抗凝治疗。本研究的主要结局是比较 USAT 后接受 DOAC 治疗的患者与 USAT 后接受 VKA 治疗的患者 90 天主要和次要出血以及复发性 VTE 的复合发生率。两组出血和复发性 VTE 的发生率相似（DOAC 组 4/42；9.5%，VKA 组 2/34；5.9%）。USAT 后使用 DOAC 治疗 VTE 与 90 天主要或次要出血或 90 天复发性 VTE 发生率的升高无关。
