de Athayde Soares Rafael, Matielo Marcelo Fernando, Brochado Neto Francisco Cardoso, Almeida Rogério Duque, Sacilotto Roberto
Division of Vascular and Endovascular Surgery, Hospital do Servidor Público Estadual de São Paulo, São Paulo, Brazil.
Division of Vascular and Endovascular Surgery, Hospital do Servidor Público Estadual de São Paulo, São Paulo, Brazil.
Ann Vasc Surg. 2020 Aug;67:293-299. doi: 10.1016/j.avsg.2020.01.017. Epub 2020 Jan 10.
In this article, we report the ultrasound aspects and recanalization rates of patients with deep venous thrombosis (DVT) in the lower limbs treated with the rivaroxaban, focusing on the recanalization rate and the ultrasonographic aspects.
This was a prospective and consecutive cohort study of patients admitted with DVT who were submitted to treatment with rivaroxaban for 6 months at the Division of Vascular and Endovascular Surgery, Hospital do Servidor Público Estadual, São Paulo, Brazil, between March 2016 and July 2018.
Fifty-one patients with DVT were admitted to the Vascular Surgery Department and received rivaroxaban for 6 months. The follow-up time was 360 days. Analyses were performed at 180 and 360 days. The rate of total venous recanalization at 360 days was 76.4% (39 patients). The incidence of partial venous recanalization was 23.5% (12 patients). At the first month, 11 patients (21.7%) continued with total occlusion of the vein, with 4 patients (6.5%) with no residual thrombi. However, at 6 months, only 2 patients (2.2%) continued with total occlusion of the vein, with 26 patients (47.8%) with no residual thrombi. At 12 months, there were 39 patients (76.4%) with no residual thrombi. Univariate and multivariate logistic regression identified the following factors related to total venous recanalization: the absence of popliteal vein reflux (odds ratio [OR], 0.386; P = 0.007), no residual thrombi (OR, 3.213; P = 0.008), femoropopliteal clot length at 1 month (OR, 3.021; P = 0.016), femoropopliteal clot length at 6 months (OR, 2.234; P = 0.008). The incidence of post-thrombotic syndrome (PTS) at 12 months was 8.3%.
In this study, patients who received oral rivaroxaban displayed satisfactory total vein recanalization rate after 6 months and 12 months. The factors associated with better total recanalization rates were the absence of popliteal vein reflux, the absence of residual thrombi in the veins, femoropopliteal clot length at 1 month (OR, 3.021; P = 0.016), and femoropopliteal clot length at 6 months (OR, 2.234; P = 0.008). Moreover, the incidence of PTS at 12 months was 8.3%.
在本文中,我们报告了接受利伐沙班治疗的下肢深静脉血栓形成(DVT)患者的超声表现及再通率,重点关注再通率和超声表现。
这是一项前瞻性连续队列研究,研究对象为2016年3月至2018年7月在巴西圣保罗州立公务员医院血管与血管内外科接受利伐沙班治疗6个月的DVT住院患者。
51例DVT患者入住血管外科并接受了6个月的利伐沙班治疗。随访时间为360天。分别在180天和360天时进行分析。360天时静脉完全再通率为76.4%(39例患者)。部分静脉再通发生率为23.5%(12例患者)。在第1个月时,11例患者(21.7%)静脉仍完全闭塞,4例患者(6.5%)无残余血栓。然而,在6个月时,只有2例患者(2.2%)静脉仍完全闭塞,26例患者(47.8%)无残余血栓。在12个月时,有39例患者(76.4%)无残余血栓。单因素和多因素逻辑回归分析确定了与静脉完全再通相关的以下因素:腘静脉反流缺失(比值比[OR],0.386;P = 0.007)、无残余血栓(OR,3.213;P = 0.008)以及1个月时股腘静脉血栓长度(OR,3.021;P = 0.016)、6个月时股腘静脉血栓长度(OR,2.234;P = 0.008)。12个月时血栓后综合征(PTS)的发生率为8.3%。
在本研究中,接受口服利伐沙班治疗的患者在6个月和12个月后显示出令人满意的静脉完全再通率。与更好的完全再通率相关的因素包括腘静脉反流缺失、静脉内无残余血栓、1个月时股腘静脉血栓长度(OR,3.021;P = 0.016)以及6个月时股腘静脉血栓长度(OR,2.234;P = 0.008)。此外,12个月时PTS的发生率为8.3%。