title: Recanalization rate in patients with proximal vein thrombosis treated with the direct oral anticoagulants.
abstract: BACKGROUND
  The recanalization rate in patients with deep venous thrombosis (DVT) of the legs treated with the direct oral anticoagulants (DOAC) is unknown.
  
  
  METHODS
  In an Italian cohort, we investigated the rate of residual vein thrombosis (RVT) after three and/or six months in 352 patients with proximal DVT who had been treated with the DOACs as a stand-alone therapy or lead-in parenteral anticoagulants, and compared it to that recorded in a historical cohort of 1094 patients in which vitamin K antagonists (VKAs) had been employed. In both cohorts, RVT was defined as the ultrasound persistence of thrombotic material resulting in a diameter of at least 4mm of incompressibility of the proximal veins.
  
  
  RESULTS
  RVT was detected in 143 patients treated with DOACs (41.2%) after three months and in 58 patients (21.1%) after six months; the corresponding figure in patients treated with conventional anticoagulation was 52.3% and 54.5%, respectively. After adjusting for the baseline characteristics, the odds ratio of RVT in patients treated with the DOACs as compared with those treated with conventional anticoagulation was 0.63 (95% CI, 0.48-0.81) after three months, and 0.17 (95% CI; 0.11-0.26) after six months.
  
  
  CONCLUSIONS
  In patients with proximal DVT treated with the DOACs, the persistence of ultrasound detectable RVT is likely to occur less frequently than in patients treated with conventional anticoagulation. These results may have implications for the prognosis of patients with DVT.
authors.affiliation: Department of Cardiovascular Sciences, Vascular Medicine Unit, University of Padua, Italy. Electronic address: paoloprandoni@tin.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Prandoni
authors.affiliation: Department of Clinical Medicine, University of Insubria, Varese, Italy.
authors.forename: Walter
authors.initials: W
authors.lastname: Ageno
authors.affiliation: Department of Internal Medicine, Hospital of Livorno, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Mumoli
authors.affiliation: Division of General Medicine, Presidio Hospital of Conegliano, Italy.
authors.forename: Nello
authors.initials: N
authors.lastname: Zanatta
authors.affiliation: Haemostasis and Thrombosis Center, Department of Internal Medicine, Hospital of Piacenza, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Imberti
authors.affiliation: Department of Angiology, S. Giacomo Apostolo Hospital, Castelfranco Veneto, Italy.
authors.forename: Adriana
authors.initials: A
authors.lastname: Visonà
authors.affiliation: Department of emergency, A.O. San Giovanni-Addolorata, Roma, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Ciammaichella
authors.affiliation: Department of Medicine, "S.Maria del Prato" Feltre Hospital, Ulss 1 Dolomiti Veneto, Italy.
authors.forename: Livio
authors.initials: L
authors.lastname: Simioni
authors.affiliation: Thrombosis Center, Hospital of Siena, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Cappelli
authors.affiliation: Department of Vascular Medicine, Hospital of Ravenna-Faenza, Italy.
authors.forename: Eugenio
authors.initials: E
authors.lastname: Bucherini
authors.affiliation: Department of Medicine and Ageing Sciences, G. D'Annunzio University, Chieti, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Di Nisio
authors.affiliation: Unit of Angiology, Department of Cardiovascular Sciences, Vascular Medicine Unit, University of Padua, Italy.
authors.forename: Giampiero
authors.initials: G
authors.lastname: Avruscio
authors.affiliation: Unit of Angiology, Department of Cardiovascular Sciences, Vascular Medicine Unit, University of Padua, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Camporese
authors.affiliation: Unit of Angiology, Internal Medicine, SS Giovanni e Paolo Hospital, Venice, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Parisi
authors.affiliation: Department of Internal Medicine, Santa Maria della Misericordia Hospital, Rovigo, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Cuppini
authors.affiliation: Department of Cardiovascular Sciences, Vascular Medicine Unit, University of Padua, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Turatti
authors.affiliation: Department of Cardiovascular Sciences, Vascular Medicine Unit, University of Padua, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Noventa
authors.affiliation: Department of Cardiovascular Sciences, Vascular Medicine Unit, University of Padua, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Sarolo
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D020246:Venous Thrombosis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D014812:Vitamin K / Q000037:antagonists & inhibitors*
chemical_list: D000925:Anticoagulants; D014812:Vitamin K
keywords: Anticoagulation; Deep venous thrombosis; Direct oral anticoagulants; Residual thrombosis; Venous thromboembolism; Vitamin K antagonists