Direct oral anticoagulant use in patients with thrombophilia, antiphospholipid syndrome or venous thrombosis of unusual sites: A narrative review

被引:18
作者
Bertoletti, Laurent [1 ,11 ,12 ]
Benhamou, Ygal [2 ]
Bejot, Yannick [3 ,10 ]
Marechaux, Sylvestre [4 ]
Cheggour, Saida [5 ]
Aleil, Boris [6 ]
Lellouche, Nicolas [7 ]
Dillinger, Jean-Guillaume [8 ]
Delluc, Aurelien [9 ,13 ]
机构
[1] CHU St Etienne, Serv Med Vasc & Therapeut, St Etienne, France
[2] Charles Nicolles Hosp, Internal Med & Vasc Med Dept, Rouen, France
[3] Univ Hosp Dijon, Dept Neurol, Burgundy, France
[4] Catholic Univ Lille, Catholic Inst Hosp Grp Lille, Dept Cardiol, Med Univ, Lille, France
[5] Hosp Henri Duffaut, Dept Cardiol, Avignon, France
[6] Cardiol Off, F-67270 Hochfelden, France
[7] Henri Mondor Hosp, Rythmol Interventionnel Dept, Creteil, France
[8] Paris Diderot Univ, Lariboisiere Hosp, AP HP,Sorbonne Paris Cite, Dept Cardiol,Anticoagulat Clin CREATIF,Inserm,U94, Paris, France
[9] Univ Occidentale Brittany, EA GETBO 3878, Brest, France
[10] Univ Burgundy, Dijon Stroke Registry, Med Sch Dijon, EA4184, Dijon, France
[11] Univ Jean Monnet, INSERM, UMR1059, Equipe Dysfonct Vasc & Hemostase, F-42055 St Etienne, France
[12] CHU St Etienne, INSERM, CIC 1408, F-42055 St Etienne, France
[13] Hosp Cavale Blanche, Dept Internal Med & Pneumol, Brest, France
关键词
Direct oral anticoagulants; Cerebral venous thrombosis; Splanchnic venous thrombosis; Inherited thrombophilia; Antiphospholipid syndrome; PROTEIN-S DEFICIENCY; PORTAL-VEIN THROMBOSIS; LONG-TERM TREATMENT; SINUS THROMBOSIS; XA INHIBITOR; CASE SERIES; THROMBOEMBOLISM; RIVAROXABAN; WARFARIN; DABIGATRAN;
D O I
10.1016/j.blre.2018.01.002
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Direct oral anticoagulants (DOACs) are indicated in the treatment and prevention of venous thromboembolism (VTE). However, the use of DOACs in unusual VTE, including cerebral venous thrombosis (CVT) and splanchnic venous thrombosis (SVT), and in patients with biological thrombophilia including minor thrombophilia (Factor V Leiden and prothrombin G20210A), major innate thrombophilia (protein C and S deficiency, and antithrombin) and major acquired thrombophilia (antiphospholipid syndrome [APS]), remains controversial due to the paucity of available data. There are some reports of DOACs use in the initial treatment or long-term maintenance of patients with either CVT or SVT, but their efficacy remains unclear. The efficacy of DOACs may be suitable in patients with biological minor or major thrombophilia. The use of DOACs for the long-term maintenance of patients with APS is more contentious. Randomized clinical trials, which are currently underway, should offer definitive insight into the efficacy and safety profiles of DOACs in these patient populations.
引用
收藏
页码:272 / 279
页数:8
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