DOAC use in SVT and CVT
• Evidence is limited but growing. Few randomized trials have been completed. |
• Most retrospective and prospective data show the DOACs are at least as effective as VKAs, and bleeding risk is not higher. |
• Multiple trials are currently accruing patients. |
• Despite being off label, in a recent survey, DOACs were used in 28% of low bleeding risk patients. |
• For patients with SVT, DOACs are contraindicated in Child-Pugh class C liver disease and for rivaroxaban in class B and C liver disease. |
• For patients with CVT, consider interactions with antiepileptic drugs, and if concomitant intracranial hemorrhage, consider initial use of a short-acting anticoagulant. |
• Evidence is limited but growing. Few randomized trials have been completed. |
• Most retrospective and prospective data show the DOACs are at least as effective as VKAs, and bleeding risk is not higher. |
• Multiple trials are currently accruing patients. |
• Despite being off label, in a recent survey, DOACs were used in 28% of low bleeding risk patients. |
• For patients with SVT, DOACs are contraindicated in Child-Pugh class C liver disease and for rivaroxaban in class B and C liver disease. |
• For patients with CVT, consider interactions with antiepileptic drugs, and if concomitant intracranial hemorrhage, consider initial use of a short-acting anticoagulant. |