| Investigating the benefit of adding a vena cava filter to anticoagulation with fondaparinux sodium in patients with cancer and venous thromboembolism in a prospective randomized clinical trial. | |
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MedLine Citation:
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PMID: 22421738 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: The benefit of adding a vena cava filter to anticoagulation in treating cancer patients with venous thromboembolism remains controversial. We initiated this study as the first prospectively randomized trial to evaluate the addition of a vena cava filter placement to anticoagulation with the factor Xa inhibitor fondaparinux sodium in patients with cancer. METHODS: Sixty-four patients with deep vein thrombosis (86 %) and/or pulmonary embolism (55 %) were randomly assigned to receive anticoagulation with fondaparinux sodium with or without a vena cava filter. Endpoints included rates of complications by treatment arm, recurrent thromboembolism, complete resolution of thromboembolism, and survival rates. RESULTS: No patient had a recurrent deep vein thrombosis; two (3 %) patients had new pulmonary emboli, one in each randomized cohort. Major bleeding occurred in three patients (5 %). Two patients on the vena cava filter arm (7 %) had complications from the filter. Median survivals were 493 days in the anticoagulation only arm and 266 days for anticoagulation + vena cava filter (p < 0.57). Complete resolution of venous thromboembolism occurred in 51 % of patients within 8 weeks of initiating anticoagulation. CONCLUSIONS: No advantage was found for placement of a vena cava filter in addition to anticoagulation with fondaparinux sodium in terms of safety, recurrent thrombosis, recurrent pulmonary embolism, or survival in this prospective randomized trial evaluating anticoagulation plus a vena cava filter in cancer patients. Favorable complete resolution rates of thrombosis were observed on both study arms. |
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Authors:
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Myra F Barginear; Richard J Gralla; Thomas P Bradley; Syed S Ali; Iuliana Shapira; Craig Greben; Nanette Nier-Shoulson; Meredith Akerman; Martin Lesser; Daniel R Budman |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-3-16 |
Journal Detail:
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Title: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer Volume: - ISSN: 1433-7339 ISO Abbreviation: - Publication Date: 2012 Mar |
Date Detail:
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Created Date: 2012-3-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9302957 Medline TA: Support Care Cancer Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Hofstra North Shore-LIJ School of Medicine, Monter Cancer Center, Lake Success, NY, USA, MBarginear@nshs.edu. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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