Novosti
Khirurgii
This journal is
indexed in Scopus



Year 2015 Vol. 23 No 4

GENERAL & SPECIAL SURGERY

DOI: http://dx.doi.org/10.18484/2305-0047.2015.4.416   |  

R.E. KALININ, I.A. SUCHKOV, A.S. PSHENNIKOV, A.B. AGAPOV

EVALUATION OF EFFICACY AND SAFETY OF DIFFERENT TYPES OF ANTICOAGULANT THERAPY IN VENOUS THROMBOSIS

SBEE HPE "Ryazan State Medical University named after Academician I.P. Pavlov",
The Russian Federation

Objectives. Evaluation of efficacy and safety of different types of anticoagulant therapy (ACT) in patients with deep venous thrombosis (DVT).
Methods. The study included 119 patients with the disease duration of 1 to 15 days. The patients were divided into three groups: the 1st group included patients (n=38) received rivaroxaban, the 2nd group included patients (n=42) who received sodium enoxaparin (for 7-10 days) with subsequent administration of warfarin, the 3rd group included patients (n=39) treated with sodium enoxaparin (for 7-10 days) with subsequent administration of rivaroxaban. The efficacy and safety of ACT were assessed by duplex ultrasonography, by recurrence incidence and hemorrhagic complications.
Results. The increase in thrombus length was observed in 24% patients in the 1st group by the 4-5th days. These patients were then treated with enoxaparin which resulted in the subsequent apex attachment to the vein wall by the 12th days.
The apex of the free-floating thrombus was attached to the vein wall by the 8-10th days in 76% of patients who received rivaroxaban. DVT duration in 4 patients (24%) did not exceed 10 days, in 14 patients (76%) it was less than 5 days. In the 2nd group the apex of the thrombus attached to the vein wall by the 8-10th day in 17 patients, while in 2 patients (5%) the free-floating thrombi were detected after more than 12 days of treatment. In group 3 the apex of the free-floating thrombus was attached to the vein wall by the 8-10th days in all patients. After 1 month of rivaroxaban treatment, the recanalization was regarded as satisfactory. Recanalization in patients treated with warfarin was considered as "moderate" or "poor". The complications caused to anticoagulant therapy developed in 20 (16,8%) out of 119 patients. The significant and major complications were observed in warfarin group.
Conclusion. Parenteral administration of anticoagulants is considerted to be an effective method of lysis of free-floating thrombi in patients with different disease duration. Rivaroxaban has more advantages compared with warfarin in early terms of satisfactory recanalization, and causes fewer major hemorrhagic complications.

Keywords: deep vein thrombosis, ultrasound duplex scanning, anticoagulant therapy, attachment of thrombus, rivaroxaban, warfarin, hemorrhagic complications
p. 416-423 of the original issue
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Address for correspondence:
390048, Russian Federation,
Ryazan, ul. Stroykova, d. 96,
GBOU VPO "Ryazanskiy gosudarstvennyiy
meditsinskiy universitet
imeni akademika I.P. Pavlova",
kafedra angiologii, sosudistoy,
operativnoy khirurgii i topograficheskoy anatomii,
tel. mob: 7 903 836-24-17,
e-mail: suchkov_med@mail.ru
Suchkov Igor Aleksandrovich
Information about the authors:
Kalinin R.E. MD, professor, a head of the angiology, vascular, operative surgery and topographic anatomy chair of SBEE HPE "Ryazan State Medical University named after Academician I.P. Pavlov".
Suchkov I.A. MD, an associate professor of the angiology, vascular, operative surgery and topographic anatomy chair of SBEE HPE "Ryazan State Medical University named after Academician I.P. Pavlov".
Pshennikov A.S. PhD, an assistant of the angiology, vascular, operative surgery and topographic anatomy chair of SBEE HPE "Ryazan State Medical University named after Academician I.P. Pavlov".
Agapov A.B. A day-time post-graduate student of the angiology, vascular, operative surgery and topographic anatomy chair of SBEE HPE "Ryazan State Medical University named after Academician I.P. Pavlov".
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