Interim Efficacy Analysis of Different Anticoagulation Regimens in Patients with Long-term Implantation of Inferior Vena Cava Filter

Abstract

Abstract: To analyze the interim efficacy of different anticoagulation regimens for patients with long-term inferior vena cava filter (IVCF) implantation. From August 2021 to August 2024, a retrospective analysis of patients who underwent long-term IVCF implantation in multiple centers was performed. Group A (46 cases) did not receive anticoagulation, Group B (66 cases) received extended secondary prophylaxis dose anticoagulation, and Group C (63 cases) received extended therapeutic dose anticoagulation, with 12 months follow-up. The primary endpoint was lower extremity deep vein thrombosis (LEDVT) recurrence rate. The secondary endpoints were IVCF thrombosis (IVCFT) incidence, bleeding-related adverse events incidence, all-cause mortality, and venous clinical severity score (VCSS). LEDVT recurrence rate and IVCFT incidence in Group A (37.0%, 19.6%) were higher than that in Group B (13.6%, 6.1%) and Group C (15.9%, 4.8%). Bleeding-related adverse events incidence in Group C (17.5%) was higher than that in Group B (4.5%) and Group A (2.2%). There was no significant difference in all-cause mortality among three groups. VCSS at 12 months in Group A was higher than that in Group B and Group C. In the interim follow-up of the extended treatment phase in patients with long-term IVCF implantation, rivaroxaban anticoagulation may reduce LEDVT recurrence and IVCFT occurrence compared to non-anticoagulation, and alleviate patients' clinical symptoms. The extended secondary prophylaxis dose may exhibit comparable efficacy to the extended therapeutic dose, while potentially reducing the bleeding risk.