title: [Efficacy of using rivaroxaban for treatment of heat-induced thrombosis after endovenous laser ablation].
abstract: OBJECTIVE
  The study was aimed at assessing efficacy of using rivaroxaban for treatment of endothermal heat-induced thrombosis (EHIT) after endovenous laser ablation (EVLA) of saphenous veins.
  
  
  METHODS
  Our prospective study included a total of 1,326 patients subjected to 1,514 EVLAs. In 1,091 (72.1%) cases the great saphenous vein (GSV) was ablated, in 124 (8.2%) cases the anterior accessory vein (AAV) was treated and in 299 (19.7%) cases the small saphenous vein (SSV) was treated. Heat-induced thrombosis developed in 21 (1.4%) cases: in 19 cases in the basin of the great saphenous vein and in 2 cases in the anterior accessory saphenous vein. No heat-induced thromboses in the basin of the small saphenous vein were observed. In 9 (0.6%) cases there was class 1 EHIT (according to the Kabnick classification), class 2 EHIT was noted in 10 (0.7%) cases and class 3 EHIT was observed in 2 (0.1%) cases. All patients with EHIT were given rivaroxaban: patients with class 1 EHIT received it at a single daily dose of 20 mg, patients with class 2 and 3 EHIT - at a dose of 15 mg twice daily. In one (4.8%) case the drug had to be discontinued on day two due to the development of dyspeptic events. All patients were found to have complete regression of the heat-induced thrombus within 6-25 days. No cases of clinical manifestations of pulmonary artery thromboembolism were observed. A conclusion was drawn that in clinical practice EHIT is an important and insufficiently studied problem. Rivaroxaban may be used as an oral agent for treatment of heat-induced thromboses after EVLA. Further studies are required to examine its efficacy and safety profile.
authors.affiliation: Department of Surgery of the Institute of Additional Professional Education of the South Ural State Medical University under the Public Health Ministry of the Russian Federation, Chelyabinsk, Russia.
authors.forename: A A
authors.initials: AA
authors.lastname: Fokin
authors.affiliation: Clinic of Phlebology and Laser Surgery, Limited Liability Company "Vasculab", Chelyabinsk, Russia.
authors.forename: D A
authors.initials: DA
authors.lastname: Borsuk
authors.affiliation: Department of Pathological Anatomy and Forensic Medicine of the South Ural State Medical University under the Public Health Ministry of the Russian Federation, Chelyabinsk, Russia.
authors.forename: E L
authors.initials: EL
authors.lastname: Kazachkov
mesh_terms: D000328:Adult; D016903:Drug Monitoring / Q000379:methods; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000379:methods; D065427:Factor Xa Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000069552:Rivaroxaban / Q000008:administration & dosage / Q000009:adverse effects; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000473:pathology; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D014648:Varicose Veins / Q000601:surgery*; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy
chemical_list: D065427:Factor Xa Inhibitors; D000069552:Rivaroxaban