de Araujo Walter Junior Boim, Timi Jorge Rufino Ribas, Erzinger Fabiano Luiz, Caron Filipe Carlos
Universidade Federal do Paraná - UFPR, Departamento de Cirurgia, Curitiba, PR, Brasil.
J Vasc Bras. 2016 Apr-Jun;15(2):147-152. doi: 10.1590/1677-5449.009816.
Endothermal heat-induced thrombosis (EHIT) is defined as propagation of a thrombus from a superficial vein into a deeper vein and is generally considered clinically insignificant if the thrombus does not propagate to the deep venous system. The condition can be treated with anticoagulation therapy, although monitoring may be sufficient, especially in less severe cases. In this paper we report on two cases of EHIT that met the criteria for indication of low molecular weight heparin until resolution of symptoms. However, the treatment actually chosen was 15 mg of rivaroxaban every 12 h and the outcomes were complete thrombus resolution in 4 weeks in Case 1 and 7 days in Case 2. Rivaroxaban may be a promising alternative for treatment of severe EHIT because the dosage regimen is simplified without compromising efficacy or safety. Prospective, randomized, controlled studies are needed to better understand EHIT and to develop more definitive recommendations on prevention and treatment options for this condition.
内热诱导血栓形成（EHIT）被定义为血栓从浅静脉延伸至深静脉，一般认为，如果血栓未蔓延至深静脉系统，临床意义不大。尽管在症状较轻的情况下，监测可能就足够了，但这种情况仍可用抗凝治疗。在本文中，我们报告了两例符合低分子量肝素使用指征标准的EHIT病例，直至症状缓解。然而，实际选择的治疗方法是每12小时服用15毫克利伐沙班，病例1在4周内血栓完全溶解，病例2在7天内血栓完全溶解。利伐沙班可能是治疗严重EHIT的一种有前景的替代药物，因为其给药方案简化，且不影响疗效或安全性。需要进行前瞻性、随机、对照研究，以更好地了解EHIT，并就该病症的预防和治疗方案制定更明确的建议。
