This study compared the efficacy of warfarin with three types of direct oral anticoagulants (DOAC) for the treatment of deep vein thrombosis (DVT) in patients who underwent orthopedic surgery. Three hundred and five DVT cases were included in this study. The thrombus resolution rates were 64.4%, 81.3%, 94.6%, and 94.8% and the number of days until thrombus resolution were 44.8, 22.2, 17.7 and 16.8 in each group (warfarin, edoxaban, rivaroxaban, apixaban). The results indicated that each of the DOACs, as compared to warfarin, showed superior efficacy in achieving thrombus resolution. Among the DOACs, rivaroxaban and apixaban which are safe to use with double-dose treatment, indicated good results. One patient in the group receiving rivaroxaban experienced intra-articular bleeding, which resolved after drainage. No patients in the other groups developed clinically significant bleeding. This study shows that DOACs, as compared to warfarin, have superior efficacy for the treatment of DVT in patients who underwent orthopedic surgery.
An 81 years old male was undergone endovascular aneurysm repair for abdominal aortic aneurysm, 50 mm in diameter with the chronic focal neck dissection. Because the main body inserted in the false lumen accidentally to be deployed, the contra-lateral leg was entrapped and undeployed by the aortic dissection flap. The upside down contra-lateral limb was deployed in the true lumen for bailout, Double-Barrel Sandwich technique was performed. Then each of stent grafts was reinforced by bare metal stents to keep each lumen. Although false lumen neck remained stenosed, postoperative course was uneventful. And we should continue careful regular observation.
After treatment of stent graft for chronic type B dissection, there are no remodeling cases because for persistent flow in the false lumen. We underwent two staged stent graft therapy and embolization of the false lumen. A 67-year-old man,thoracic and abdominal aorta were enlarged because of remained entry and re-entry flow. The entry tear was closed by TEVAR and the thoracic false lumen was thrombosed. Abdominal false lumen was not thrombosed because the flow from the re-entry. We added the embolization of the false lumen and EVAR. A stent graft therapy with false lumen embolization for chronic type B dissection is useful, but we need more careful observation.