Franco-Moreno Anabel, Madroñal-Cerezo Elena, Martínez-Casa-Muñoz Ana, Ortiz-Sánchez Judith, Ancos-Aracil Cristina Lucía
Venous Thromboembolism Unit, Department of Internal Medicine, Hospital Universitario Infanta Leonor, Avenida Gran Via del Este, 80, 28031 Madrid, Spain.
Venous Thromboembolism Unit, Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Camino del Molino, 2, Fuenlabrada, 28942 Madrid, Spain.
Pharmaceutics. 2025 Mar 7;17(3):342. doi: 10.3390/pharmaceutics17030342.
Direct oral anticoagulants (DOACs) have emerged as the preferred oral anticoagulant therapy for patients with deep vein thrombosis of the lower extremities and pulmonary embolism. DOACs offer several advantages over vitamin K antagonists, including fixed dosage, fewer drug interactions, faster onset of action, and a lower risk of major bleeding, especially intracranial. Although evidence on the use of DOACs in unusual-site venous thrombosis (USVT) is limited, their use in such cases is becoming increasingly common. This narrative review examines the evidence derived from randomized controlled trials, and large observational studies focused on the use of the DOACs in USVT, including cerebral, splanchnic, upper extremity, ovarian, renal, and retinal vein thrombosis. In addition, it also provides practical advice for their use in these clinical settings according to the updated scientific literature.
直接口服抗凝剂（DOACs）已成为下肢深静脉血栓形成和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具有多种优势，包括固定剂量、较少的药物相互作用、起效更快以及大出血风险较低，尤其是颅内出血风险。尽管关于DOACs在非寻常部位静脉血栓形成（USVT）中应用的证据有限，但它们在这类病例中的使用正变得越来越普遍。这篇叙述性综述考察了来自随机对照试验以及专注于DOACs在USVT中应用的大型观察性研究的证据，包括脑静脉、内脏静脉、上肢静脉、卵巢静脉、肾静脉和视网膜静脉血栓形成。此外，它还根据最新的科学文献为在这些临床环境中使用DOACs提供实用建议。
