Rivaroxaban in deep vein thrombosis: an analysis of results in a clinical case series

BACKGROUND: The treatment of deep vein thrombosis (DVT) has significantly advanced in recent years, with direct oral anticoagulants (DOACs), such as rivaroxaban, showing efficacy and safety in managing this condition. This prospective study aimed to evaluate the clinical effectiveness of rivaroxaban in patients diagnosed with DVT, focusing on clinical improvement, thrombus recanalization, and valve function preservation.METHODS: A cohort of patients diagnosed with proximal and distal DVT was treated with rivaroxaban in an outpatient setting. Clinical outcomes, including pain relief, reduction of edema, thrombus recanalization, and valve function preservation, were assessed at two and six months. Data were analyzed in the context of the COVID-19 pandemic, which influenced treatment modalities.RESULTS: A total of 62% of the patients were women, with a median age of 53 years. A rapid clinical improvement was observed, with 91% of patients experiencing relief from pain and heaviness within 72 hours. Patients with distal DVT showed a faster reduction in edema compared to those with proximal DVT. Recanalization rates at two months were 41% for proximal DVT and 21% for distal DVT, with total recanalization observed in 29% of distal cases. Notably, 82% of patients with distal DVT preserved valve function. The most common adverse events were mild gastrointestinal bleeding, mostly attributed to hemorrhoids, which were managed with temporary suspension of rivaroxaban.CONCLUSIONS: Rivaroxaban proved to be an effective and safe treatment for DVT, leading to significant clinical improvement, thrombus recanalization, and preservation of valve function. These findings support rivaroxaban as a preferred therapeutic option, especially in the outpatient setting, and align with existing evidence in the field.