Dual-Channel Inhibition With Rivaroxaban and Aspirin for Thromboprophylaxis in Patients With Long-Term Inferior Vena Cava Filter Implantation: A Two-Center Cohort Study.

BackgroundInferior vena cava filter (IVCF) is used to prevent pulmonary embolism (PE) due to deep vein thrombosis (DVT), and some filters are indwelling for a long time, which increase the risk of thrombotic events. Single-channel anticoagulation is still inadequate in the prevention of thrombosis. This study aims to explore the efficacy and safety of rivaroxaban combined with aspirin versus rivaroxaban alone in the prevention of thrombotic events in patients with long-term IVCF implantation.MethodsA retrospective analysis was conducted on patients with long-term IVCF implantation in the two centers from August 2021 to October 2024. Among them, 58 cases were in the single-channel (SC) group, who only took rivaroxaban orally after surgery, and 61 cases were in the dual-channel (DC) group, who took rivaroxaban and aspirin orally after surgery. The follow-up period was 12 months. The primary endpoint was the incidence of combined venous thromboembolism (VTE). The secondary endpoints were the recurrence rate of lower extremity DVT, the incidence of IVCF thrombosis (IVCFT), PE, and adverse events, Venous Clinical Severity Score (VCSS) and Chronic Venous Insufficiency Questionnaire (CIVIQ-20).ResultsThe incidence of combined VTE in Group SC (14/58, 24.1%) was higher than that in Group DC (6/61, 9.8%) (HR: 0.38, 95% CI: 0.14-0.98, P=0.037). The incidence of IVCFT, VCSS and CIVIQ-20 at 12 months in Group SC were higher than those in Group DC. There were no significant differences in the incidence of DVT recurrence, PE, bleeding-related adverse events, and all-cause mortality between the two groups.ConclusionFor patients with long-term IVCF implantation, compared with rivaroxaban alone, the dual-channel inhibition of rivaroxaban combined with aspirin may reduce the occurrence of thrombotic events, alleviate clinical symptoms and improve the quality of life of patients, without increasing the risk of adverse events such as bleeding.