Anticoagulant therapy in deep venous thrombosis. A randomized controlled study

Area of Science:

• Vascular Medicine
• Thrombosis Research
• Clinical Pharmacology

Background:

• Deep venous thrombosis (DVT) management often involves anticoagulation.
• Early mobilization and compression stockings are standard care for DVT patients.
• The efficacy of anticoagulant (AC) treatment in actively mobilized DVT patients requires further investigation.

Purpose of the Study:

• To compare the safety and efficacy of anticoagulant treatment versus non-anticoagulant treatment in patients with deep venous thrombosis (DVT) and no clinical signs of pulmonary embolism (PE).
• To assess the impact of anticoagulant therapy on DVT progression and pulmonary embolism development in actively mobilized patients.

Main Methods:

• Ninety patients with venographically proven DVT were randomized into AC and non-AC groups.
• Both groups received early mobilization and graduated compression stockings.
• The non-AC group received phenylbutazone, while the AC group received heparin followed by oral anticoagulants.
• Venography, perfusion-ventilation lung scans, and assessment of bleeding complications were performed.

Main Results:

• No significant difference in DVT regression was observed between the AC and non-AC groups for distal or proximal veins.
• Lung scan results showed no significant difference in pulmonary embolism incidence between the groups at 10 and 60 days.
• The incidence of bleeding complications in the AC group was 8.3%; phenylbutazone had no reported side-effects.

Conclusions:

• Anticoagulant treatment did not demonstrate a significant effect on DVT progression in actively mobilized patients using compression stockings compared to non-AC therapy with phenylbutazone.
• The study's small patient population and wide confidence intervals limit definitive conclusions.
• Larger, placebo-controlled studies are necessary to establish the role of AC treatment in early mobilized DVT patients.