Rivaroxaban for the prevention of venous thromboembolism after radiofrequency ablation of saphenous veins concomitant with miniphlebectomy, sclerotherapy, or no treatment of varicose tributaries

Murzina, Elena; Lobastov, Kirill; Laberko, Leonid; Дворников, А. С.; Popov, I. B.

doi:10.1177/02683555211017336

Cited by 8 publications

(4 citation statements)

References 32 publications

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“…Only two of the studies referred to recanalization of the target vein however the incidence was so low that no statistical analysis could be carried out. Keo et al (2019), 7 reports 6 partial occlusions and 2 complete recanalization’s at 1 month follow-up, while Murzina et al (2021), 10 reports none at 1 month and 5 recanalization’s at 12 months. It is known from the literature that there is a correlation between long term anticoagulation and failure of ablation, however it is not clear if short term anticoagulation accelerates recanalization.…”

Section: Discussionmentioning

confidence: 99%

Pharmacological Thromboprophylaxis for VTE Post-Endovenous Ablation of Varicose Veins: Network Meta-Analysis

Westby,

Gasior,

Twyford

et al. 2024

Vasc Endovascular Surg

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Objective Endovenous ablation has revolutionized treatment of varicose vein surgery but is associated with a risk of venous thromboembolism. There is no consensus regarding anticoagulation protocols for these patients. This network meta-analysis (NMA) aims to identify which anticoagulant is optimal in this cohort for clot prevention with minimal risk of adverse bleeding events. Methods Library databases were searched for studies where patients were treated with one or more anticoagulants following endovenous ablation for varicose veins. The methodological quality of included studies was quantified using the Risk of Bias (ROB) assessment tools. Findings were reported using the meta-analysis of observational studies in epidemiology (MOOSE) checklist. Statistical analysis was carried out using metainsight (rpackage). Results Observational data on just under 1500 patients prescribed post ablation anticoagulation (Rivaroxaban, Enoxaparin, Fondaparinux) were analyzed. Patient characteristics were comparable across the cohorts. 81 thrombotic and 40 minor bleeding events occurred in total. Overall rivaroxaban is found to be superior to the other agents. Conclusions This NMA indicates that prophylactic rivaroxaban is the highest ranked anticoagulant for thromboprophylaxis in patients post endovenous ablation for varicose veins, with a low risk of adverse bleeding. The choice whether to anticoagulate these patients is likely to remain at the discretion of the treating clinician.

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Section: Discussionmentioning

confidence: 99%

Pharmacological Thromboprophylaxis for VTE Post-Endovenous Ablation of Varicose Veins: Network Meta-Analysis

Westby,

Gasior,

Twyford

et al. 2024

Vasc Endovascular Surg

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“…На сегодняшний день известно 5 работ по данному вопросу, включая упомянутую ранее статью (табл. 2) [33,[36][37][38][39]. Одно ретроспективное наблюдательное исследование оценивало влияние приема препарата в течение 5-10 дней на риск развития ЭТИТ [36], в то время как два других (по-видимому, являющихся вариантами анализа одной базы данных) ретроспективным образом сравнили использование ривароксабана 10 мг на протяжении 3 и 10 дней с подкожным введением фондапаринукса 2,5 мг в течение 3 дней [37,38].…”

Section: возможности применения прямых оральных антикоагулянтов для п...unclassified

“…Одно ретроспективное наблюдательное исследование оценивало влияние приема препарата в течение 5-10 дней на риск развития ЭТИТ [36], в то время как два других (по-видимому, являющихся вариантами анализа одной базы данных) ретроспективным образом сравнили использование ривароксабана 10 мг на протяжении 3 и 10 дней с подкожным введением фондапаринукса 2,5 мг в течение 3 дней [37,38]. В рамках последнего ретроспективного анализа сравнивалась эффективность и безопасность применения ривароксабана и эноксапарина после РЧА стволовых вен [39]. Все изученные подходы обладали сопоставимой эффективностью без значительных отличий по риску развития ВТЭО и кровотечения.…”

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Current state of the problem of risk assessment and prevention of venous thromboembolic complications after thermal obliteration of superficial veins

Lobastov

Shaldina²,

Борсук

et al. 2022

Ambulatornaya khirurgiya

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Venous thromboembolic complications (VTEO) after modern minimally invasive superficial vein interventions are an infrequent but very dramatic event. This article presents a review of the literature, covering the issues of prevalence, prognosis and pharmacological prevention of VTEO. The performed studies demonstrate that the incidence of symptomatic thrombotic complications after endovenous thermal obliteration does not exceed 0,5%, but taking into account asymptomatic thermally induced thromboses and subclinical occlusions of the muscular veins of the lower leg, this figure can exceed 10%. There is a high heterogeneity of the data, possibly due to differences in the individual risk of VTEO. The most validated tool for assessing the latter is the Caprini Scale, which has not been sufficiently studied in the surgical treatment of varicose veins. The administration of prophylactic doses of anticoagulants after thermal obliteration of saphenous veins is widely used in routine clinical practice, despite the lack of convincing evidence for the appropriateness of this approach. In recent years, the use of direct oral anticoagulants against the official instruction (off-label) has gained great popularity as an alternative to heparin. The largest evidence base has accumulated for the use of rivaroxaban 10 mg, which is associated with high efficacy and safety. Based on completed clinical trials, it is not possible to formulate unequivocal recommendations for prophylactic anticoagulant doses after thermal obliteration of superficial veins at this time. Additional studies are required to identify patients with an individually increased risk of thrombosis in whom prophylactic doses of anticoagulants may be of maximum benefit.

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Enoxaparin-sodium

2021

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Enoxaparin-sodium Subcutaneous haematoma: case reportIn a retrospective, observational study of 297 patients treated for varicose veins using radiofrequency ablation (RFA) at one clinical centre in Russian Federation in between 2015 and 2020, a patient [age and sex not stated] was described who developed subcutaneous haematoma following anticoagulant therapy with enoxaparin-sodium.The patient who had varicose veins underwent RFA for its treatment. For the prophylaxis of venous thromboembolism (VTE), the patient started receiving SC enoxaparin-sodium [enoxaparin] injection 40mg 12h before, 12h after the RFA and then every 24h for five days. However, following therapy, the patient developed subcutaneous haematoma in the zone of miniphlebectomy [time to reaction onset not stated].The haematoma required an additional draining. Further, it was classified as clinically relevant non-major (CRNM) bleeding. The haematoma was attributed to the enoxaparin-sodium.

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Rivaroxaban for the prevention of venous thromboembolism after radiofrequency ablation of saphenous veins concomitant with miniphlebectomy, sclerotherapy, or no treatment of varicose tributaries

Cited by 8 publications

References 32 publications

Pharmacological Thromboprophylaxis for VTE Post-Endovenous Ablation of Varicose Veins: Network Meta-Analysis

Pharmacological Thromboprophylaxis for VTE Post-Endovenous Ablation of Varicose Veins: Network Meta-Analysis

Current state of the problem of risk assessment and prevention of venous thromboembolic complications after thermal obliteration of superficial veins

Enoxaparin-sodium

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