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Outcomes of endovascular venous stenting in patients on direct oral anticoagulants and antiplatelet therapy at a tertiary referral center
- Source :
- Journal of vascular surgery. Venous and lymphatic disorders. 9(3)
- Publication Year :
- 2020
-
Abstract
- Background Endovenous revascularization is the standard in the management of acute thrombotic, chronic post-thrombotic iliocaval or iliofemoral obstruction, and nonthrombotic iliac vein lesions. The purpose of this study is to describe our single-center experience of postprocedure anticoagulation and antiplatelet regimens used after endovenous revascularization for a variety of venous occlusive conditions. Methods We conducted a retrospective analysis of 100 consecutive patients who underwent endovenous stenting for iliocaval or iliofemoral obstruction from January 1, 2014, to April 30, 2018. Patients treated with direct oral anticoagulants, warfarin, or low-molecular-weight heparin (LMWH) with or without antiplatelet therapy were identified. Demographic, procedural, patency, and follow-up data were collected. Stent patency was evaluated using duplex Doppler ultrasound examination or contrast venography. Results Seventy-one of 100 patients were treated with direct oral anticoagulant therapy (DOAC). Sixteen (23%) were lost to follow-up, leaving 55 (77%) available for analysis. The mean follow-up was 14 months (range, 1-43 months) with 32 patients (58%) followed for 12 months or longer. Primary, primary-assisted, and secondary-assisted patency rates were 87%, 97%, and 98%, respectively, at 12 months. In the non-DOAC group (patients treated with warfarin or LMWH), these rates were 87%, 93%, and 95%, respectively, at 12 months. Antiplatelet therapy, including clopidogrel, aspirin, or both, was used in 53 of 55 patients in the DOAC cohort and 18 of 19 patients in the non-DOAC group. Conclusions Our-single center retrospective analysis demonstrates acceptable primary patency rates when using DOAC therapy compared with those treated with warfarin or LMWH.
- Subjects :
- Male
medicine.medical_specialty
Time Factors
medicine.drug_class
medicine.medical_treatment
Venography
Low molecular weight heparin
Administration, Oral
Hemorrhage
030204 cardiovascular system & hematology
Revascularization
Postthrombotic Syndrome
Tertiary Care Centers
03 medical and health sciences
0302 clinical medicine
medicine
Humans
030212 general & internal medicine
Vein
Vascular Patency
Retrospective Studies
Venous Thrombosis
Aspirin
medicine.diagnostic_test
business.industry
Endovascular Procedures
Warfarin
Anticoagulants
Vitamin K antagonist
Heparin, Low-Molecular-Weight
Middle Aged
Clopidogrel
Surgery
medicine.anatomical_structure
Treatment Outcome
Chronic Disease
Female
Stents
Cardiology and Cardiovascular Medicine
business
Platelet Aggregation Inhibitors
medicine.drug
Factor Xa Inhibitors
Subjects
Details
- ISSN :
- 22133348
- Volume :
- 9
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Journal of vascular surgery. Venous and lymphatic disorders
- Accession number :
- edsair.doi.dedup.....c8de35bd47899620dd5c14d88b52a304