Efficacy of using rivaroxaban for treatment of heat-induced thrombosis after endovenous laser ablation

• Published in: Angiologii͡a︡ i sosudistai͡a︡ khirurgii͡a Vol. 22; no. 4; p. 97
• Main Authors: Fokin, A A, Borsuk, D A, Kazachkov, E L
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) 2016
• Subjects: Adult; Drug Monitoring - methods; Endovascular Procedures - adverse effects; Endovascular Procedures - methods; Factor Xa Inhibitors - administration & dosage; Factor Xa Inhibitors - adverse effects; Female; Humans; Laser Therapy - adverse effects; Laser Therapy - methods; Male; Middle Aged; Prospective Studies; Rivaroxaban - administration & dosage; Rivaroxaban - adverse effects; Saphenous Vein - diagnostic imaging; Saphenous Vein - pathology; Treatment Outcome; Ultrasonography, Doppler, Color - methods; Varicose Veins - surgery; Venous Thrombosis - diagnosis; Venous Thrombosis - etiology; Venous Thrombosis - therapy
• ISSN: 1027-6661

The study was aimed at assessing efficacy of using rivaroxaban for treatment of endothermal heat-induced thrombosis (EHIT) after endovenous laser ablation (EVLA) of saphenous veins. Our prospective study included a total of 1,326 patients subjected to 1,514 EVLAs. In 1,091 (72.1%) cases the great saphenous vein (GSV) was ablated, in 124 (8.2%) cases the anterior accessory vein (AAV) was treated and in 299 (19.7%) cases the small saphenous vein (SSV) was treated. Heat-induced thrombosis developed in 21 (1.4%) cases: in 19 cases in the basin of the great saphenous vein and in 2 cases in the anterior accessory saphenous vein. No heat-induced thromboses in the basin of the small saphenous vein were observed. In 9 (0.6%) cases there was class 1 EHIT (according to the Kabnick classification), class 2 EHIT was noted in 10 (0.7%) cases and class 3 EHIT was observed in 2 (0.1%) cases. All patients with EHIT were given rivaroxaban: patients with class 1 EHIT received it at a single daily dose of 20 mg, patients with class 2 and 3 EHIT - at a dose of 15 mg twice daily. In one (4.8%) case the drug had to be discontinued on day two due to the development of dyspeptic events. All patients were found to have complete regression of the heat-induced thrombus within 6-25 days. No cases of clinical manifestations of pulmonary artery thromboembolism were observed. A conclusion was drawn that in clinical practice EHIT is an important and insufficiently studied problem. Rivaroxaban may be used as an oral agent for treatment of heat-induced thromboses after EVLA. Further studies are required to examine its efficacy and safety profile.