Efficacy and Safety of Direct Oral Anti-Coagulants in Painful Venous Malformations in Children.

Direct oral anticoagulants (DOAC), including dabigatran, apixaban, and rivaroxaban, are increasingly used in adults for painful venous malformations (VMs) instead of subcutaneous drugs such as low molecular weight heparins or fondaparinux. However, these medications are poorly studied in children. In seven children with painful VMs and chronic intravascular consumptive coagulopathy, DOACs allowed for successful pain control and improvement in coagulopathy, with no adverse effects. DOACs appear to be an effective alternative in childhood VM associated with intravascular coagulopathy.