Oral Rivaroxaban Versus Warfarin After inferior Vena cava Filter Implantation: A Retrospective Cohort Study

Area of Science:

• Cardiology
• Vascular Surgery
• Pharmacology

Background:

• Inferior vena cava (IVC) filters are used to prevent pulmonary embolism in patients with deep vein thrombosis (DVT).
• Anticoagulation is crucial after IVC filter placement, but optimal agent choice remains debated.
• Warfarin and rivaroxaban are common anticoagulants used in this setting.

Purpose of the Study:

• To compare the efficacy and safety of rivaroxaban versus warfarin in patients following IVC filter implantation.
• To evaluate outcomes related to venous thromboembolism (VTE) recurrence and bleeding events.

Main Methods:

• Retrospective analysis of 100 patients with DVT undergoing IVC filter implantation.
• Patients received either warfarin (n=41) or rivaroxaban (n=59) for 3-12 months.
• Outcomes assessed included symptomatic VTE recurrence and bleeding events at 12-month follow-up.

Main Results:

• No VTE recurrence was observed in the rivaroxaban group, compared to 7.3% in the warfarin group.
• One major bleeding event occurred with warfarin; three clinically relevant non-major bleedings occurred with rivaroxaban.
• Propensity score matching showed no significant differences in outcomes between the two groups.

Conclusions:

• Rivaroxaban appears to be a safe and effective alternative to warfarin after IVC filter implantation.
• Further prospective studies may be warranted to confirm these findings.