Does Rivaroxaban have a fibrinolytic effect?

Aim The study started from the observation of complete recanalization of thrombus in subjects with DVT treated with rivaroxaban after 1-2 weeks. Aim of this clinical-instrumental observational retrospective research is to evaluate clinically and by means of Echo color Duplex the fibrinolytic effect of Rivaroxaban in patients with recent and previous DVT. Methods We evaluated two populations of patients: 1st group: 27 patients males (range of age 50-73 years) with popliteal-femoral DVT (12 months before) treated with standard anticoagulant therapy. In this patients we found a complete superficial femoral recanalization and partial recanalization of the popliteal vein (30% of residual thrombus). The patients had normal creatinine clearance and liver function. The patients switched from warfarin to rivaroxaban for no compliance to warfarin. 2nd group: 19 patients (range of age 65-85 years) with previous popliteal-femoral DVT and complete common femoral veins recanalization (already know or documented). The patients presented recent superficial femoral vein re-thrombosis (1 week before). The patients had normal creatinine clearance and liver function. Results 1st group: we observed in all patients the complete recanalization of the popliteal veins. 2nd group: we observed in all patients the complete recanalization of the superficial femoral veins after 2 weeks of the therapy of Rivaroxaban and complete recanalization of the popliteal veins after 4 weeks. No adverse events for both groups were observed. Conclusion According to our results, we consider that Rivaroxaban could have a fibrinolytic effect not only on recent thrombus but also on organized thrombus with, as result, a complete recanalization of affected veins and consequent reduction of incidence of post-thrombotic syndrome saving the valves structure.