|Table of Contents|

Application of rivaroxaban bridging strategy in the treatment of percutaneous biopsy combined with microwave ablation in patients with lung nodules who are receiving antithrombotic therapy

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2024 20
Page:
3879-3885
Research Field:
Publishing date:

Info

Title:
Application of rivaroxaban bridging strategy in the treatment of percutaneous biopsy combined with microwave ablation in patients with lung nodules who are receiving antithrombotic therapy
Author(s):
WANG Nan; XUE Tianyu; XU Jingwen; YE Xin
Department of Oncology,Shandong Province Qianfoshan Hospital,Shandong Province Traditional Chinese Medicine University,Shandong Jinan 250014,China.
Keywords:
lung ground-glass opacities; antithrombotic therapy; microwave ablation; biopsy; safety; effectiveness
PACS:
R734.2
DOI:
10.3969/j.issn.1672-4992.2024.20.011
Abstract:
Objective:To evaluate the safety and efficacy of rivaroxaban as a bridge drug in the treatment of synchronous percutaneous biopsy and microwave ablation (B+MWA) for highly suspicious malignant lung ground-glass opacities (GGOs) in patients on antithrombotic therapy.Methods:The study comprised 138 patients with pulmonary GGOs receiving antithrombotic therapy.All patients underwent 138 synchronous CT-guided percutaneous B+MWA from January 1,2020 to December 31,2021.The patients were divided into two groups:Patients in Group A,received rivaroxaban (10 mg/d) 5 days before procedure,stopped 1 day before procedure,and resumed the original dose as soon as possible 3 days after procedure.Patients in Group B,directly stopped all antithrombotic drugs 5 days before procedure and resumed as soon as possible 3 days after procedure.The technical success rate,biopsy positive rate,local control rate (LCR),hemorrhagic and thrombosis complications in the two groups were collected and analyzed.Complications were graded according to the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) standard,major complications were defined as grade of complications more than 3 level.Results:Group A comprised 58 patients ［male:39,female:19,mean age±SD:(71.12±6.46)years］,and Group B comprised 80 patients ［male:55,female:25,mean age±SD:(70.72±7.33)years］.The technical success rate was 100% in both groups.The positive biopsy rates in Group A and Group B were 94.83%（55/58） and 96.25%（77/80）,respectively (P=0.423 6).The LCR of Group A and Group B at 1,6,12,and 24 months were 100.0% vs 98.75%,96.55% vs 98.75%,96.55% vs 93.75% and 89.66% vs 91.25%,respectively.During the periprocedural and follow-up period,there was no significant difference in major hemorrhagic complications between the two groups.However,the incidence of major thrombotic complications in Group B (11.25%,9/80) was significantly higher than that in Group A (1.72%,1/58) during the follow-up period from 3 days postoperatively to 1 month postoperatively (P=0.033 1).Conclusion:Compared with the strategy of directly stopping anticoagulant drugs during the periprocedural period,rivaroxaban as a bridge drug is safe and effective in synchronous percutaneous B+MWA for highly suspicious malignant lung ground-glass opacities (GGOs) in patients on antithrombotic therapy,and it can reduce the incidence of major thrombotic complications during the periprocedural period.

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Memo

Memo:
中国博士后科学基金(编号：2022M711979)；山东省济南市临床医学科技创新计划项目（编号：202225074）；山东省千佛山医院国家自然培育基金（编号：QYPY2021NSFC0608）
Last Update: 1900-01-01