Department of Pharmacy, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
Department of Vascular Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
BMC Cardiovasc Disord. 2022 Sep 11;22(1):406. doi: 10.1186/s12872-022-02849-6.
Non-retrieved inferior vena cava filter (IVCF) is associated with some severe complications, such as filter thrombosis. The aim of this retrospective cohort study was to evaluate the outcome of rivaroxaban for the prevention of filter thrombosis in patients with non-retrieved IVCF.
The study based on the VTE registry databases was limited to patients with non-retrieved IVCF treated at Nanjing Drum Tower Hospital from January 2012 to December 2017. Outcomes included filter thrombosis, total bleeding events, death.
A total of 202 patients were enrolled in the study and divided into rivaroxaban group and warfarin group. Mean follow-up period of the two groups was 57.4 ± 20.8 and 62.2 ± 23.0 months, respectively. In risk factors for VTE, transient factors (P = 0.008) and history of VTE (P = 0.028) were statistically different between the two groups. A total of 13 (6.4%) patients developed filter complications, of which 4 (3.5%) and 5 (5.7%) patients in rivaroxaban group and warfarin group developed filter thrombosis, respectively, without significant difference (P = 0.690). The total bleeding events in rivaroxaban group, including major bleeding and clinically relevant and non-major (CRNM) bleeding, were significantly lower than that in warfarin group (P = 0.005). Adjusting for hypertension, transient risk factors, history of VTE and cancer, no differences in the hazard ratio for outcomes were notable.
It is necessary to perform a concomitant anticoagulation in patients with non-retrieved filters. Rivaroxaban can be an alternative anticoagulant option for the prevention of filter thrombosis.
未取出的下腔静脉滤器（IVCF）与一些严重并发症相关，如滤器血栓形成。本回顾性队列研究的目的是评估利伐沙班预防未取出 IVCF 患者滤器血栓形成的效果。
该研究基于 VTE 登记数据库，仅限于 2012 年 1 月至 2017 年 12 月在南京鼓楼医院接受未取出 IVCF 治疗的患者。结果包括滤器血栓形成、总出血事件和死亡。
共纳入 202 例患者，分为利伐沙班组和华法林组。两组的平均随访时间分别为 57.4±20.8 个月和 62.2±23.0 个月。在 VTE 的危险因素中，两组间的一过性因素（P=0.008）和 VTE 病史（P=0.028）有统计学差异。共有 13（6.4%）例患者发生滤器并发症，其中利伐沙班组和华法林组分别有 4（3.5%）和 5（5.7%）例患者发生滤器血栓形成，差异无统计学意义（P=0.690）。利伐沙班组的总出血事件，包括大出血和临床相关非大出血（CRNM）出血，明显低于华法林组（P=0.005）。调整高血压、一过性危险因素、VTE 病史和癌症后，结果的危险比无显著差异。
对于未取出的滤器患者，有必要进行抗凝治疗。利伐沙班可以作为预防滤器血栓形成的抗凝选择。
