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Randomized Comparison of Thrombus Resolution Outcome between Direct Xa Inhibitor Anticoagulant and Warfarin In Acute Deep Vein Thrombosis
J Surg Ultrasound 2020;7:29-35
Published online November 30, 2020;  https://doi.org/10.46268/jsu.2020.7.2.29
© 2020 The Korean Surgical Ultrasound Society

Jae Hoon Lee, Ki Hyuk Park

Division of Vascular Surgery, Department of Surgery, Daegu Catholic University School of Medicine, Daegu, Korea
Correspondence to: Ki Hyuk Park
Division of Vascular Surgery, Department of Surgery, Daegu Catholic University School of Medicine, 17-33 St. Dooryou-Gongwon, Nam-gu, Daegu 42472, Korea
Tel: +82-53-650-4065
Fax: +82-53-624-7185
E-mail: khpark@cu.ac.kr
Received July 24, 2020; Revised September 13, 2020; Accepted September 15, 2020.
Journal of Surgical Ultrasound is an Open Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: Newly developed factor Xa inhibitor anticoagulants (Xaban) produced non-inferior outcomes in terms of venous thromboembolism (VTE) recurrence and safety. On the other hand, thrombus resolution (TR), a factor associated with VTE recurrence and post-thrombotic syndrome, was not expressed clearly in these studies. This study compared the long-term TR outcomes in patients treated with Xaban or warfarin.
Methods: Fifty-seven acute deep vein thrombosis (DVT) patients were enrolled. After the initial heparin therapy, randomly assigned patients received oral Xaban or warfarin. The time in the therapeutic range was maintained at more than 60% during the anticoagulation period. After 3–12 months on the medication, a duplex scan was performed to diagnose the thrombus changes.
Results: Unprovoked DVT occurred in 80.7% of patients (46/57), and the mean age was 60.1 ± 13.99 years; 26 patients were female. Concurrent pulmonary embolism was diagnosed in 20 patients (52.6%) in the Xaban group and 10 (52.6%) in the warfarin group. The complete TR rate for the proximal venous segment was 47.4% (18/38) for the Xaban group and 57.9% (11/19) for the warfarin group. Complete DVT TR was observed in 26.3% of patients (10/38) in the Xaban group and 42.1% (8/19) in the warfarin group. No significant difference was observed between the proximal (P = 0.657) and complete TR rates (P = 0.227) between the two groups.
Conclusion: Xaban administration for acute DVT showed no difference in TR compared to warfarin. Xaban could also be an easy-to-use anticoagulation treatment option because it does not require monitoring and has a short half-life.
Keywords : Deep vein thrombosis, Anticoagulants, Warfarin


November 2020, 7 (2)