The Effectiveness of New Oral Anticoagulants in the Treatment of Lower Extremity Venous Thrombosis: A Retrospective Clinical Study

Year 2021, Volume: 13 Issue: 2, 312 - 318, 07.06.2021

Ekin İlkeli Ali Cemal Düzgün

https://doi.org/10.18521/ktd.807493

Abstract

Objective: This clinical study included a retrospective evaluation of 138 patients using new oral anticoagulants (rivaroxaban, dabigatran, apixaban, edoxaban) for lower extremity deep vein thrombosis. The demographic characteristics of the patients and the relationship between the disease, treatment initiation and end times, radiological and clinical recovery, and NOACSSS side effects were evaluated.

Materials and Method: 138 patients using new oral anticoagulant drugs were included in the retrospective study. Demographic characteristics, diagnosis and treatment charts, radiological images, epicrisis notes of the patients were recorded. Records of each patient were reviewed during their 12 months of follow-up. New oral anticoagulant efficacy; It was evaluated by measuring thigh and calf diameters before and after treatment, whether there was recanalization in Doppler USG (recanalization> 75%), recanalization time, bleeding side effects and recovery times with treatment, and recurrence rates. The data were analyzed statistically using a statistics program.

Results: A significant difference was found when the mean thigh diameter measurements measured at the beginning of the treatment (Mean ± SD: 75,41) and the mean thigh diameter measured after the treatment (Mean ± SD: 54,63) were compared. P <0.05. A significant difference was found when the mean calf diameter measurements (Mean ± SD: 43.99) measured at the beginning of the treatment and the mean calf diameter measured after the treatment were compared. P <0.05. Post-treatment Doppler USG showed complete recanalization rate in 54% (75 patients) at 3 months and 25% (35 patients) at 6 months. At the end of the 6th month, the total recanalization rate occurred in 80% (110) patients.

Conclusion: New oral anticoagulants (rivaroxaban, dabigatran, apixaban, edoxaban) are very effective in the treatment of lower extremity deep venous thrombosis, both in providing recanalization and in terms of clinical improvement. There were acceptable side effects in accordance with the literature.

Keywords

New oral anticoagulants, deep vein thrombosis, thrombophilia

Alt Ekstremite Venöz Tromboz Tedavisinde Yeni Oral Antikoagulanların Etkinliği: Retrospektif Klinik Çalışma

Abstract

Amaç: Bu klinik çalışma alt ekstremite derin ven trombozu nedeniyle yeni oral antikoagulan ilaç (rivaroksaban, dabigatran,apiksaban, edoksaban) kullanan 138 hastanın retrospektif olarak incelenmesini içermektedir. Hastaların demografik özellikleri ile hastalık ilişkisi, tedavi başlangıç- bitiş süreleri, radyolojik ve klinik iyileşme durumları, yeni oral antikoagulanların yan etkileri değerlendirilmiştir.

Metod: Retrospektif çalışmaya yeni oral antikoagulan ilaç kullanan 138 hasta dahil edildi. Hastaların demografik özellikleri, tanı ve tedavi şemaları, radyolojik görüntüleri, epikriz notları kayıt edildi. Her bir hastanın kayıtları takip edildikleri 12 ay boyunca incelendi. Yeni oral antikoagulan etkinliği; tedavi öncesi ve sonrası uyluk ve baldır çaplarının ölçülmesi, doppler USG’de rekanalizasyon olup olmadığı (rekanalizasyon>%75), rekanalizasyon süresi, kanama yan etkileri ve tedavi ile iyileşme süreleri, rekürrens oranları ölçülerek değerlendirildi. Veriler istatistik programı kullanılarak istatiksel olarak incelendi.

Bulgular: Tedavi başlangıcında ölçülen uyluk çap ölçümleri ortalaması (Ort±SS:75,41 ) ile tedavi sonrası ölçülen uyluk çap ortalaması (Ort±SS:54,63) karşılaştırıldığında anlamlı fark bulundu. P<0.05. Tedavi başlangıcında ölçülen baldır çap ölçümleri ortalamaları (Ort±SS:43,99) ile tedavi sonrası ölçülen baldır çap ortalaması karşılaştırıldığında anlamlı fark bulundu. P<0.05.Hastalarda tedavi sonrası doppler USG de tam rekanalizasyon oranı 3.ayda % 54 (75 hasta) ,6 ayda % 25 (35 hasta) da görüldü.6.ay sonunda toplam rekanalizasyon oranı %80 (110) hastada gerçekleşmiştir.

Sonuç: Yeni oral antikoagulanlar (rivaroksaban, dabigatran,apiksaban, edoksaban) alt ekstremite derin venöz tromboz tedavisinde hem rekanalizasyonun sağlanmasında hem klinik düzelme anlamında oldukça etkilidir. Kabul edilebilir ve literatürle uyumlu oranda yan etkileri görülmüştür.

Keywords

Antikoagülan ajanlar, derin ven trombozu, trombofili

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