Novel Anticoagulant Treatment for Pulmonary Embolism with Direct Oral Anticoagulants Phase 3 Trials and Clinical Practice

摘要

Anticoagulant therapy is the cornerstone of therapeutic management in acute venous thromboembolism (VTE), consisting of pulmonary embolism and deep vein thrombosis. Direct oral anticoagulants (DOACs) have become the standard of care because of their good safety profile and ease of use in clinical practice. Indeed, phase 3 randomized trials (AMPLIFY, EINSTEIN, RECOVER, and HOKUSAI studies) showed that DOACs provided a similar efficacy and a better safety than conventional treatment with parenteral heparin with overlapping loading dose of vitamin K antagonists in acute VTE therapeutic management. The results of published data from real-world registries confirm the safety and efficacy of DOACs demonstrated in the phase 3 trials. Objectives: Upon completion of this article, the reader will be able to discuss the role of anticoagulants in the interventional radiology population, as well as differentiate between the most commonly used agents in these drug classes. Anticoagulation is the cornerstone of acute venous thromboembolism (VTE) treatment including pulmonary embolism (PE) and deep venous thrombosis (DVT). The goal of anticoagulation is to prevent thrombus extension and development of new thrombi. Conventional treatment consists of parenteral treatment, usually low-molecular-weight heparin (LMWH), for at least 5 days.