Oral anticoagulants, effect on thrombus resolution and post-thrombotic syndrome

Introduction: Venous thromboembolism is a frequently occurring phenomenon with a high risk of acute and chronic complications. To prevent these, subjects are treated with surgical options to restore venous blood flow combined with medical treatment or medical treatment alone. Despite great therapeutic advances considerable morbidity still persists. For example, thrombosis of the leg can result in post-thrombotic syndrome, which has a great impact on quality of life. The best management to prevent the post-thrombotic syndrome is a topic of research and debate. In this study, we searched the literature to identify studies that used oral anticoagulants and evaluated their properties for resolution of thrombus and hence prevention of the post-thrombotic syndrome.

Methods: We searched PubMed, The Cochrane Library, and four international medical journals frequently reporting on venous thromboembolism. Furthermore, we looked at Clinicaltrials.gov for current research on this topic.

Results: Only three suitable articles were identified.

Discussion: We found experimental evidence that direct thrombin inhibitors and factor Xa inhibitors have an influence on clot lysis favoring a quicker recanalization compared to warfarin. Future studies investigating these effects in humans are warranted.