Why the study?
Permanent inferior vena cava filter (IVCF) placement carries risks of complications such as filter fracture and thrombotic occlusion, prompting guidelines to recommend retrievable filters with minimal indwelling time.
Does switching to rivaroxaban resolve inferior vena cava filter thrombus in a patient with chronic venous thromboembolism under continuous warfarin therapy?
Case Report (n=1)
No
Does switching to rivaroxaban resolve inferior vena cava filter thrombus in a patient with chronic venous thromboembolism under continuous warfarin therapy?
Rivaroxaban may be an effective and safe alternative for treating inferior vena cava filter thrombosis that develops despite continuous warfarin therapy.
May support rivaroxaban for warfarin-refractory IVC filter thrombus; leaves open need for prospective trials.
下大静脈フィルター（inferior vena cava filter: IVCF）は静脈血栓塞栓症（venous thromboembolism: VTE）治療の補完医療機器として汎用されてきたが，IVCFの傾斜や位置移動，脚の穿孔といった合併症が懸念される．とくに永久留置となった場合には，これらの合併症に加えてIVCFの破損やIVCF血栓閉塞にも注意しなければならない．そのため，現在ガイドラインでは，IVCF留置に際して回収可能型IVCFの選択かつ最低限の留置期間にするよう提唱されている．今回，急性VTEの診断で留置したIVCFが永久留置となり，ワルファリンで抗凝固療法を継続していたにもかかわらず，留置後7年目にとくに誘因なくIVCF血栓症を発症し，抗凝固薬をリバーロキサバンに変更後約1カ月でIVCF内の血栓が消退し得た1例を経験したので報告する．
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Okajima et al. (2020) conducted a case report in Inferior vena cava filter thrombus (n=1). Rivaroxaban vs. Warfarin (prior therapy) was evaluated on Thrombus resolution.
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