Direct oral anticoagulants for unusual‐site venous thromboembolism

• Main Authors: Nicoletta Riva, Walter Ageno
• Format: Article
• Language: English
• Published: Wiley 2021-02-01
• Series: Research and Practice in Thrombosis and Haemostasis
• Subjects: Budd‐Chiari syndrome; cranial sinus thrombosis; direct‐acting oral anticoagulants; portal vein; upper extremity deep vein thrombosis; venous thromboembolism
• Online Access: https://doi.org/10.1002/rth2.12480

Abstract Direct oral anticoagulants (DOACs) are currently the preferred oral anticoagulant treatment for most of the patients with deep vein thrombosis of the lower extremities and/or pulmonary embolism. DOACs have several advantages over vitamin K antagonists, such as availability of fixed dosages, fewer drug interactions, faster onset of action, shorter half‐life, and lower risk of major and intracranial bleeding. Although the evidence on the use of DOACs in patients with unusual‐site venous thromboembolism (VTE) is limited to a few, small randomized controlled trials, these drugs are increasingly used in clinical practice, and several observational cohort studies have been published recently. This narrative review will describe the latest evidence for the use of the DOACs in patients with thrombosis in atypical locations (splanchnic, cerebral, upper extremity, ovarian, and renal vein thrombosis) and will provide some practical advice for their use in patients with unusual‐site VTE.