Piati Polyana Klomfass, Peres Aline Krampe, de Andrade Danielle Oliveira, Jorge Mirela Andressa, Toregeani Jeferson Freitas
Faculdade Assis Gurgacz - FAG, Cascavel, PR, Brasil.
J Vasc Bras. 2019 Jun 17;18:e20180111. doi: 10.1590/1677-5449.180111.
Deep venous thrombosis (DVT) strikes around ten million people worldwide every year and is associated with major complications including pulmonary embolism and post-thrombotic syndrome. Anticoagulation is the standard treatment, with administration of heparins, vitamin K antagonists, fondaparinux, or, more recently, direct oral anticoagulants (DOACs). Anticoagulants reduce thrombus progression and facilitate natural thrombolytic mechanisms, leading to a phenomenon known as recanalization, which can occur in varying degrees and over variable periods of time, under influence from many different factors, including the type of anticoagulation employed.
To evaluate the degree of recanalization and the time taken, by analysis of color Doppler ultrasonography (CDU) reports from patients with DVT treated with DOACs or with heparin + warfarin.
A retrospective analysis was conducted of demographic data and CDU reports from patients with DVT who had been treated from January 2009 to December 2016. These patients were classified into two groups, according to the treatment given: Group I (heparin + warfarin): 26 patients; or Group II (rivaroxaban): 51 patients. The primary outcomes assessed were degree of recanalization and time taken.
Recanalization rates at 30, 90, and 180 days were 10%, 52.5%, and 78.9%, respectively, in Group I, and 55.3%, 83.5%, and 92.4%, respectively, in Group II, with statistically significant difference (p = 0.041).
Both treatments led to recanalization. Recanalization occurred earlier among patients treated with rivaroxaban.
每年全球约有1000万人发生深静脉血栓形成（DVT），其与包括肺栓塞和血栓形成后综合征在内的主要并发症相关。抗凝是标准治疗方法，可使用肝素、维生素K拮抗剂、磺达肝癸钠，或者最近使用的直接口服抗凝剂（DOACs）。抗凝剂可减少血栓进展并促进自然溶栓机制，从而导致一种称为再通的现象，在包括所用抗凝类型在内的许多不同因素影响下，再通可在不同程度和不同时间段内发生。
通过分析接受DOACs或肝素+华法林治疗的DVT患者的彩色多普勒超声（CDU）报告，评估再通程度和所需时间。
对2009年1月至2016年12月接受治疗的DVT患者的人口统计学数据和CDU报告进行回顾性分析。根据所给予的治疗方法，将这些患者分为两组：第一组（肝素+华法林）：26例患者；第二组（利伐沙班）：51例患者。评估的主要结局为再通程度和所需时间。
第一组在30、90和180天时的再通率分别为10%、52.5%和78.9%，第二组分别为55.3%、83.5%和92.4%，差异有统计学意义（p = 0.041）。
两种治疗均导致再通。接受利伐沙班治疗的患者再通发生得更早。
