Abstract 19736: Rivaroxaban and Apixaban for Treatment of Venous Thrombosis of Atypical Location
Background: Effectiveness and safety of novel oral anticoagulants (NOACs) for treatment of venous thrombosis of “atypical” location such as: portal, mesenteric, hepatic, splenic, gonadal, renal, and cerebral veins is essentially unexplored.
Methods: Consecutive patients treated with rivaroxaban or apixaban for venous thromboembolism (VTE), enrolled into Mayo Thrombophilia Registry between March 1, 2013, and May 30, 2016, were followed prospectively.
Results: During study period there were 604 VTE patients [544 with typical (leg deep vein thrombosis or pulmonary embolism) and 60 with atypical location], and 286 (79 treated with apixaban) had at least 3 months of follow up. Of these, 24 (8%) had atypical VTE: portal (9), ovarian (6), mesenteric (6), renal (3), splenic (1), and cerebral (1); one patient had portal and mesenteric, another ovarian and renal thrombosis. Patients with atypical VTE were younger compared to typical VTE patients; two-third of them had malignancy (see Table). Two patients in atypical VTE group (both with cancer and treated with rivaroxaban) experienced recurrent thrombosis (8.3%), compared to 6 patients in the typical VTE group (2.3%, p=0.129). There was the same rate of major bleeding in both groups. Over 20% of atypical VTE patients died during study follow up compared to 9% in typical VTE group.
Conclusion: This is the first study looking at the use of NOACs in VTE patients of atypical location. Rivaroxaban and apixaban seem to be a reasonable therapy for this group, however further studies are necessary to better assess the safety and particularly efficacy of this therapy.
Author Disclosures: M. Mimier: None. D. Janczak: None. B. Simmons: None. C. Lenz: None. D. Bott-Kitslaar: None. R. Saadiq: None. T. Ransone: None. P. Kamath: None. R. McBane: None. W. Wysokinski: None.
- © 2016 by American Heart Association, Inc.