Rivaroxaban Treatment in Acute Proximal DVT Patients with Malignancy

Chiu-Yang Lee

Department of Surgery, Division of Cardiovascular Surgery, Taipei Veterans General Hospital, Taiwan
Department of Senior Citizen Service Management, Chia Nan University of Pharmacy and Science, Taiwan

^*Correspondance to: Chiu-Yang Lee 

 PDF  Full Text DOI: 10.25107/2474-1647.2056

Abstract

Background: The primary objective of this study was to evaluate efficacy and safety of rivaroxaban treatment in patients with active malignancy and acute proximal deep vein thrombosis (DVT).Methods: This study comprised 34 patients with active cancer and acute proximal DVT, who received rivaroxaban treatment for at least 5 months. The study endpoints included the rate of thrombus regression, treatment efficacy and safety, which were assessed with frequent duplex ultrasounds, plethysmography, and commutated tomography. The mean duration of the follow-up was 25.2 months.Results: Of 34 patients with cancer, 31 suffered from active malignancy. 15 patients had breast carcinoma, and 5 had lung cancer in this study. At 3, 6, 12, and 24 months, cumulative patency was observed in 11.8%, 38.2 %, 44.1%, and 55.90% of all patients. Femoral valvular incompetence was found in 21 (61.8%) patients. 19 patients developed post thrombositc syndrome (PTS) at 12 months, and the mean PTS score was 5.9 ± 3.3. Of 34 patients, 9 patients had bleeding events. 9 (26.5%) patients developed recurrent deep vein thrombosis, and 3(7.5%) had pulmonary embolism during follow-up.Conclusion: This study indicated extended-duration rivaroxaban therapy should be considered for acute unprovoked proximal DVT. Large-scale prospective studies should be conducted in cancer associated DVT patients in the future.

Keywords

Deep vein thrombosis; Post-thrombotic syndrome; Valvular incompetence

Cite the article

Lee C-Y. Rivaroxaban Treatment in Acute Proximal DVT Patients with Malignancy. Clin Surg. 2018; 3: 2056.