下腔静脉滤器植入术后口服利伐沙班与华法林的比较：一项回顾性队列研究。
Oral Rivaroxaban Versus Warfarin After inferior Vena cava Filter Implantation: A Retrospective Cohort Study.
机构信息
Department of General Surgery, Pirogov Russian National Research Medical University, Moscow, Russia.
Clinical Hospital No. 1 of the President's Administration of the Russian Federation, Moscow, Russia.
出版信息
Clin Appl Thromb Hemost. 2024 Jan-Dec;30:10760296241256938. doi: 10.1177/10760296241256938.
OBJECTIVES
To assess the efficacy and safety of rivaroxaban compared to warfarin after inferior vena cava (IVC) filter implantation.
METHOD
This retrospective analysis includes data from 100 patients with deep vein thrombosis (DVT) who underwent IVC filter implantation due to a free-floating thrombus (n = 64), thrombus propagation (n = 8), or acute bleeding (n = 8) on therapeutic anticoagulation, catheter-directed thrombolysis (n = 8), or had previously implanted filter with DVT recurrence. Patients were treated with warfarin (n = 41) or rivaroxaban (n = 59) for 3-12 months. Symptomatic venous thromboembolism (VTE) recurrence and bleeding events were assessed at 12 months follow-up.
RESULTS
Three (7.3%) cases of VTE recurrence without IVC filter occlusion occurred on warfarin and none on rivaroxaban. The only (2.4%) major bleeding occurred on warfarin. Three (5.1%) clinically relevant non-major bleedings were detected on rivaroxaban. No significant differences existed between groups when full and propensity scores matched datasets were compared.
CONCLUSIONS
Rivaroxaban seems not less effective and safe than warfarin after IVC filter implantation.
目的
评估利伐沙班相对于华法林在植入下腔静脉（IVC）滤器后的疗效和安全性。
方法
这项回顾性分析纳入了 100 例因游离血栓（n=64）、血栓蔓延（n=8）、或因在接受治疗性抗凝、导管定向溶栓（n=8）治疗期间发生急性出血，或因先前植入的滤器导致 DVT 复发而接受 IVC 滤器植入的深静脉血栓（DVT）患者的数据。患者接受华法林（n=41）或利伐沙班（n=59）治疗 3-12 个月。在 12 个月随访时评估症状性静脉血栓栓塞（VTE）复发和出血事件。
结果
华法林组有 3 例（7.3%）无 IVC 滤器阻塞的 VTE 复发，而利伐沙班组无一例复发。华法林组仅发生 1 例（2.4%）重大出血。利伐沙班组检测到 3 例（5.1%）有临床意义的非重大出血。在全匹配和倾向评分匹配数据集进行比较时，两组之间没有显著差异。
结论
在植入 IVC 滤器后，利伐沙班似乎与华法林一样有效且安全。
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