Efficacy of Direct Oral Anticoagulants for the Treatment of Deep Vein Thrombosis in Orthopedic Perioperative Patients

Kensuke Takeuchi

doi:10.7133/jca.17-00025

January 1, 2018The Journal of Japanese College of AngiologyOpen Access

Efficacy of Direct Oral Anticoagulants for the Treatment of Deep Vein Thrombosis in Orthopedic Perioperative Patients

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Why the study?

Do DOACs improve thrombus resolution rates and times compared to warfarin in patients with postoperative DVT after orthopedic surgery?

Structured PICO

Do DOACs improve thrombus resolution rates and times compared to warfarin in patients with postoperative DVT after orthopedic surgery?

P

Population

300 patients with deep vein thrombosis (DVT) diagnosed postoperatively after knee osteoarthritis surgery, mean age 70.0, 35 male/265 female, treated at a single center in Japan.

I

Intervention

Direct oral anticoagulants (DOACs) for 3 months: Edoxaban (n=134, 30 or 60 mg), Rivaroxaban (n=56, with or without initial intensive therapy), or Apixaban (n=58, with or without initial intensive therapy).

C

Comparator

Warfarin (n=52) with target PT-INR 2, preceded by 5 days of intravenous Urokinase.

O

Outcome

Thrombus resolution rate and number of days until complete thrombus resolution assessed by ultrasound.surrogate

DOACs, particularly rivaroxaban and apixaban, demonstrated superior efficacy in achieving faster and higher rates of thrombus resolution compared to warfarin for postoperative DVT in orthopedic patients.

Limitations

Retrospective design
Use of urokinase instead of unfractionated heparin in the warfarin group

Implication

DOACs may accelerate perioperative orthopedic VTE resolution versus warfarin; Level 5 data leaves open the need for RCTs to confirm safety and guide selection.

Abstract

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Discussion

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Cite This Study

Kensuke Takeuchi (2018) studied this question.

synapsesocial.com/papers/6a73ea54c973d0bd5a69f9c6 https://doi.org/10.7133/jca.17-00025

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Efficacy of Direct Oral Anticoagulants for the Treatment of Deep Vein Thrombosis in Orthopedic Perioperative Patients

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Efficacy of Direct Oral Anticoagulants for the Treatment of Deep Vein Thrombosis in Orthopedic Perioperative Patients

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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