One-year treatment outcomes in patients with lower extremity deep vein thrombosis
DOI:
https://doi.org/10.30978/GS-2026-2-22Keywords:
deep vein thrombosis, venous thromboembolism, direct oral anticoagulants, warfarin, rivaroxaban, apixaban, dabigatran, recanalization, recurrent deep vein thrombosisAbstract
Lower extremity deep vein thrombosis remains one of the leading causes of venous thromboembolism and is associated with the risk of pulmonary embolism, post-thrombotic syndrome, and disease recurrence. In contemporary clinical practice, direct oral anticoagulants (DOACs) are considered an alternative to traditional anticoagulant therapy using low-molecular-weight heparin and warfarin. However, the outcomes of their use in real-world clinical practice require further investigation.
Objective – to evaluate the treatment outcomes of acute deep vein thrombosis of the lower extremities in patients receiving conventional anticoagulant therapy with low-molecular-weight heparin and Warfarin, compared with those treated with direct oral anticoagulants, focusing on recanalization, recurrence of venous thromboembolism, and treatment safety in real-world clinical practice.
Materials and methods. A single-center retrospective comparative cohort study was conducted involving 217 patients with acute lower extremity deep vein thrombosis treated between 2020 and 2025. The traditional therapy group included 82 patients who received low-molecular-weight heparin followed by transition to warfarin, whereas the DOAC group included 135 patients treated with rivaroxaban, dabigatran, or apixaban. The primary endpoints were venous segment recanalization and recurrence of venous thromboembolism during the 12-month follow-up period.
Results. At 3 months after treatment initiation, complete venous segment recanalization was achieved in 18.0% of patients, partial recanalization in 71.0% of patients, while no recanalization was observed in 11.1% of patients. There was no statistically significant difference between the groups in the degree of recanalization (p=0.839). The one-year recurrence rate of venous thromboembolism was 8.8%: 7.3% in the traditional therapy group and 9.6% in the DOAC group (p=0.557). No significant difference in recurrence rates was identified among the different agents within the DOAC group. No major hemorrhagic complications or anticoagulant therapy-related deaths were recorded in this study.
Conclusions. Traditional anticoagulant therapy with low-molecular-weight heparin followed by warfarin and direct oral anticoagulants demonstrated comparable clinical efficacy in the treatment of acute lower extremity deep vein thrombosis: after 3 months, complete or partial venous segment recanalization was achieved in 89.0% of patients, with no statistically significant difference between the groups (p=0.839). The absence of major hemorrhagic complications and anticoagulant therapy-related mortality indicates a satisfactory safety profile for both traditional anticoagulant therapy and direct oral anticoagulants in the treatment of acute lower extremity deep vein thrombosis in real-world clinical practice.
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