Riva Nicoletta, Ageno Walter
Department of Pathology, Faculty of Medicine and Surgery University of Malta Msida Malta.
Department of Medicine and Surgery University of Insubria Varese Italy.
Res Pract Thromb Haemost. 2021 Jan 28;5(2):265-277. doi: 10.1002/rth2.12480. eCollection 2021 Feb.
Direct oral anticoagulants (DOACs) are currently the preferred oral anticoagulant treatment for most of the patients with deep vein thrombosis of the lower extremities and/or pulmonary embolism. DOACs have several advantages over vitamin K antagonists, such as availability of fixed dosages, fewer drug interactions, faster onset of action, shorter half-life, and lower risk of major and intracranial bleeding. Although the evidence on the use of DOACs in patients with unusual-site venous thromboembolism (VTE) is limited to a few, small randomized controlled trials, these drugs are increasingly used in clinical practice, and several observational cohort studies have been published recently. This narrative review will describe the latest evidence for the use of the DOACs in patients with thrombosis in atypical locations (splanchnic, cerebral, upper extremity, ovarian, and renal vein thrombosis) and will provide some practical advice for their use in patients with unusual-site VTE.
直接口服抗凝剂（DOACs）目前是大多数下肢深静脉血栓形成和/或肺栓塞患者首选的口服抗凝治疗药物。与维生素K拮抗剂相比，DOACs具有几个优点，如固定剂量、较少的药物相互作用、起效更快、半衰期更短以及严重出血和颅内出血风险更低。尽管关于DOACs在非典型部位静脉血栓栓塞（VTE）患者中应用的证据仅限于少数小型随机对照试验，但这些药物在临床实践中越来越多地被使用，并且最近发表了几项观察性队列研究。本叙述性综述将描述DOACs在非典型部位（内脏、脑、上肢、卵巢和肾静脉血栓形成）血栓形成患者中应用的最新证据，并将为其在非典型部位VTE患者中的应用提供一些实用建议。
