{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T11:37:42Z","timestamp":1792237062291,"version":"4.4.0"},"reference-count":146,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T00:00:00Z","timestamp":1745366400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Direct oral anticoagulants (DOACs) have emerged as a preferred alternative to vitamin K antagonists (VKAs) for the prevention and treatment of thromboembolic disorders, offering improved safety, predictable pharmacokinetics, and ease of administration. Despite these advantages, their use in complex clinical scenarios presents significant challenges that necessitate individualized therapeutic strategies. This comprehensive review explores the efficacy, safety, and limitations of DOAC therapy in special populations, including patients with renal or hepatic impairment, obesity, cancer-associated thrombosis, and antiphospholipid syndrome. Additionally, we examine their role in uncommon thrombotic conditions such as superficial venous thrombosis, embolic stroke of undetermined source, upper extremity vein thrombosis, inferior vena cava thrombosis, pelvic vein thrombosis, and cerebral vein thrombosis. The pharmacokinetic variability of DOACs in renal and hepatic dysfunction requires caution to balance the bleeding and thrombotic risks. In obesity, altered drug distribution and metabolism raise concerns regarding appropriate dosing and therapeutic efficacy. Cancer-associated thrombosis presents a complex interplay of prothrombotic mechanisms, necessitating careful selection of anticoagulant therapy. Furthermore, the use of DOACs in antiphospholipid syndrome remains controversial due to concerns about recurrent thrombotic events. Finally, in some unusual scenarios like inferior vena cava, pelvic vein, and cerebral vein thrombosis, the use of DOACs has scarce evidence. This review aims to guide clinicians in optimizing anticoagulation management in challenging patient populations by synthesizing current evidence and providing practical recommendations.<\/jats:p>","DOI":"10.3390\/jcm14092914","type":"journal-article","created":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T10:40:48Z","timestamp":1745404848000},"page":"2914","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Challenges and Opportunities of Direct Oral Anticoagulant (DOAC) Therapy in Complex Clinical Scenarios: A Comprehensive Review and Practical Guide"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4797-2523","authenticated-orcid":false,"given":"Giuseppe","family":"Miceli","sequence":"first","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE) Universit\u00e0 degli Studi di Palermo, Piazza delle Cliniche 2, 90127 Palermo, Italy"},{"name":"Internal Medicine and Stroke Care Ward, University Hospital, Policlinico \u201cP. Giaccone\u201d, 90100 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Maria","family":"Ciaccio","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE) Universit\u00e0 degli Studi di Palermo, Piazza delle Cliniche 2, 90127 Palermo, Italy"},{"name":"Internal Medicine and Stroke Care Ward, University Hospital, Policlinico \u201cP. Giaccone\u201d, 90100 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6440-7318","authenticated-orcid":false,"given":"Antonino","family":"Tuttolomondo","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE) Universit\u00e0 degli Studi di Palermo, Piazza delle Cliniche 2, 90127 Palermo, Italy"},{"name":"Internal Medicine and Stroke Care Ward, University Hospital, Policlinico \u201cP. Giaccone\u201d, 90100 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e017559","DOI":"10.1161\/JAHA.120.017559","article-title":"Direct Oral Anticoagulant Use: A Practical Guide to Common Clinical Challenges","volume":"9","author":"Chen","year":"2020","journal-title":"J. Am. Heart Assoc."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"9538","DOI":"10.3390\/nu7115479","article-title":"New Insights into the Pros and Cons of the Clinical Use of Vitamin K Antagonists (VKAs) Versus Direct Oral Anticoagulants (DOACs)","volume":"7","author":"Schurgers","year":"2015","journal-title":"Nutrients"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1182\/asheducation-2018.1.432","article-title":"Breadth of Complications of Long-Term Oral Anticoagulant Care","volume":"2018","author":"Ageno","year":"2018","journal-title":"Hematol. Am. Soc. Hematol. Educ. Program"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1111\/jth.12969","article-title":"Recommendation on the Nomenclature for Oral Anticoagulants: Communication from the SSC of the ISTH","volume":"13","author":"Barnes","year":"2015","journal-title":"J. Thromb. Haemost."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1182\/blood-2010-02-261891","article-title":"Rebalanced Hemostasis in Patients with Liver Disease: Evidence and Clinical Consequences","volume":"116","author":"Lisman","year":"2010","journal-title":"Blood"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1172\/JCI105380","article-title":"Pooling of Platelets in the Spleen: Role in the Pathogenesis of \u201cHypersplenic\u201d Thrombocytopenia","volume":"45","author":"Aster","year":"1966","journal-title":"J. Clin. Investig."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1160\/TH16-06-0450","article-title":"The Risk of Venous Thromboembolism in Patients with Cirrhosis: A Systematic Review and Meta-Analysis","volume":"117","author":"Ambrosino","year":"2017","journal-title":"Thromb. Haemost."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1055\/s-0040-1714205","article-title":"Incidence of Bleeding and Thrombosis in Patients with Liver Disease","volume":"46","author":"Roberts","year":"2020","journal-title":"Semin. Thromb. Hemost."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2725","DOI":"10.1002\/hep.32019","article-title":"Risk and Outcome of Venous and Arterial Thrombosis in Patients with Cirrhosis: A Danish Nationwide Cohort Study","volume":"74","author":"Jepsen","year":"2021","journal-title":"Hepatology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1111\/jth.15239","article-title":"The Concept of Rebalanced Hemostasis in Patients with Liver Disease: Communication from the ISTH SSC Working Group on Hemostatic Management of Patients with Liver Disease","volume":"19","author":"Lisman","year":"2021","journal-title":"J. Thromb. Haemost."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"102293","DOI":"10.1016\/j.rpth.2023.102293","article-title":"Venous Thromboembolism, Chronic Liver Disease and Anticoagulant Choice: Effectiveness and Safety of Direct Oral Anticoagulants versus Warfarin","volume":"8","author":"Lawal","year":"2023","journal-title":"Res. Pract. Thromb. Haemost."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1111\/liv.13285","article-title":"Antithrombotic Treatment with Direct-Acting Oral Anticoagulants in Patients with Splanchnic Vein Thrombosis and Cirrhosis","volume":"37","author":"Trebicka","year":"2017","journal-title":"Liver Int."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1093\/eurheartj\/ehy136","article-title":"The 2018 European Heart Rhythm Association Practical Guide on the Use of Non-Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation","volume":"39","author":"Steffel","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1053\/S0016-5085(21)03587-3","article-title":"AGA Clinical Practice Guideline on the Management of Coagulation Disorders in Patients with Cirrhosis","volume":"161","author":"Davitkov","year":"2021","journal-title":"Gastroenterology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1016\/j.jhep.2021.09.003","article-title":"EASL Clinical Practice Guidelines on Prevention and Management of Bleeding and Thrombosis in Patients with Cirrhosis","volume":"76","author":"Villa","year":"2022","journal-title":"J. Hepatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1111\/bcp.12054","article-title":"Effect of Hepatic Impairment on the Pharmacokinetics and Pharmacodynamics of a Single Dose of Rivaroxaban, an Oral, Direct Factor Xa Inhibitor","volume":"76","author":"Kubitza","year":"2013","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"682","DOI":"10.4254\/wjh.v14.i4.682","article-title":"Direct Oral Anticoagulant Administration in Cirrhotic Patients with Portal Vein Thrombosis: What is the Evidence?","volume":"14","author":"Biolato","year":"2022","journal-title":"World J. Hepatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1007\/s12325-020-01550-4","article-title":"Anticoagulation Favors Thrombus Recanalization and Survival in Patients with Liver Cirrhosis and Portal Vein Thrombosis: Results of a Meta-Analysis","volume":"38","author":"Wang","year":"2021","journal-title":"Adv. Ther."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1007\/s11239-021-02424-4","article-title":"Safety of Direct Oral Anticoagulants in Patients with Mild to Moderate Cirrhosis: A Systematic Review and Meta-Analysis","volume":"52","author":"Nisly","year":"2021","journal-title":"J. Thromb. Thrombolysis"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1097\/MEG.0000000000001846","article-title":"Efficacy and Safety Study of Direct-Acting Oral Anticoagulants for the Treatment of Chronic Portal Vein Thrombosis in Patients with Liver Cirrhosis","volume":"32","author":"Ai","year":"2020","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.coph.2021.07.006","article-title":"When and How to Use Direct Oral Anticoagulants in Patients with Advanced Chronic Liver Disease?","volume":"60","author":"Galante","year":"2021","journal-title":"Curr. Opin. Pharmacol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.thromres.2024.03.024","article-title":"Effectiveness and Safety of Direct Oral Anticoagulants Among Patients with Non-Valvular Atrial Fibrillation and Liver Disease: A Multinational Cohort Study","volume":"237","author":"Douros","year":"2024","journal-title":"Thromb. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3295","DOI":"10.1016\/j.jacc.2019.04.052","article-title":"Direct Oral Anticoagulants in Patients with Atrial Fibrillation and Liver Disease","volume":"73","author":"Lee","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_24","unstructured":"Hitawala, A.A., and Gupta, V. (2025, March 15). Budd\u2013Chiari Syndrome, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK558941\/."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1111\/ejh.14363","article-title":"Direct Oral Anticoagulants in Budd\u2013Chiari Syndrome","volume":"114","author":"Thapa","year":"2025","journal-title":"Eur. J. Haematol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1182\/hematology.2023000481","article-title":"How to Manage Splanchnic Vein Thrombosis in Patients with Liver Disease","volume":"2023","author":"Riva","year":"2023","journal-title":"Hematol. Am. Soc. Hematol. Educ. Program"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1566","DOI":"10.1016\/j.jhep.2023.06.001","article-title":"A Major Research Gap: The Use of Anticoagulants in Cirrhosis","volume":"79","author":"Senzolo","year":"2023","journal-title":"J. Hepatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2110","DOI":"10.1016\/j.cgh.2023.04.016","article-title":"Bleeding and Thrombotic Complications in Patients with Cirrhosis: A State-of-the-Art Appraisal","volume":"21","author":"Rautou","year":"2023","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.jhepr.2019.02.006","article-title":"Anticoagulation in the Cirrhotic Patient","volume":"1","author":"Turco","year":"2019","journal-title":"JHEP Rep."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1027882","DOI":"10.3389\/fmed.2022.1027882","article-title":"Venous Thromboembolism in In-Hospital Cirrhotic Patients: A Systematic Review","volume":"9","author":"Tustumi","year":"2022","journal-title":"Front. Med."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group (2024). KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int., 105, S117\u2013S314.","DOI":"10.1016\/j.kint.2023.10.018"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e342","DOI":"10.1016\/S2214-109X(24)00050-0","article-title":"The Major Global Burden of Chronic Kidney Disease","volume":"12","author":"Jadoul","year":"2024","journal-title":"Lancet Glob. Health"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2982","DOI":"10.1016\/j.jacc.2020.11.010","article-title":"Global Burden of Cardiovascular Diseases and Risk Factors, 1990\u20132019: Update from the GBD 2019 Study","volume":"76","author":"Roth","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e002340","DOI":"10.1136\/openhrt-2023-002340","article-title":"Correct Dosing, Adherence and Persistence of DOACs in Atrial Fibrillation and Chronic Kidney Disease: A Systematic Review and Meta-Analysis","volume":"10","author":"Emanuel","year":"2023","journal-title":"Open Heart"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1056\/NEJMoa1009638","article-title":"Rivaroxaban versus Warfarin in Nonvalvular Atrial Fibrillation","volume":"365","author":"Patel","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2104","DOI":"10.1253\/circj.CJ-12-0454","article-title":"Rivaroxaban vs. Warfarin in Japanese Patients with Atrial Fibrillation\u2014The J-ROCKET AF Study","volume":"76","author":"Hori","year":"2012","journal-title":"Circ. J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1056\/NEJMoa1107039","article-title":"Apixaban versus Warfarin in Patients with Atrial Fibrillation","volume":"365","author":"Granger","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1056\/NEJMoa0905561","article-title":"Dabigatran versus Warfarin in Patients with Atrial Fibrillation","volume":"361","author":"Connolly","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2093","DOI":"10.1056\/NEJMoa1310907","article-title":"Edoxaban versus Warfarin in Patients with Atrial Fibrillation","volume":"369","author":"Giugliano","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1748","DOI":"10.1161\/CIRCULATIONAHA.122.062752","article-title":"Direct Oral Anticoagulants Versus Warfarin Across the Spectrum of Kidney Function: Patient-Level Network Meta-Analyses from COMBINE AF","volume":"147","author":"Harrington","year":"2023","journal-title":"Circulation"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Wing, S.L., Mavrakanas, T.A., and Harel, Z. (2024). Oral Anticoagulation Use in Individuals with Atrial Fibrillation and Chronic Kidney Disease: A Review. Seminars in Nephrology, WB Saunders.","DOI":"10.1016\/j.semnephrol.2024.151517"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1093\/ehjqcco\/qcac069","article-title":"Kidney Function and the Comparative Effectiveness and Safety of Direct Oral Anticoagulants vs. Warfarin in Adults with Atrial Fibrillation: A Multicenter Observational Study","volume":"9","author":"Jun","year":"2023","journal-title":"Eur. Heart J. Qual. Care Clin. Outcomes"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.ahj.2020.01.010","article-title":"Rivaroxaban versus Warfarin in Patients with Nonvalvular Atrial Fibrillation and Stage IV\u2013V Chronic Kidney Disease","volume":"223","author":"Weir","year":"2020","journal-title":"Am. Heart J."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"4264","DOI":"10.1007\/s12325-023-02544-8","article-title":"Prescription of DOACs in Patients with Atrial Fibrillation at Different Stages of Renal Insufficiency","volume":"40","author":"Hahn","year":"2023","journal-title":"Adv. Ther."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1735","DOI":"10.1056\/NEJMoa2012883","article-title":"Low-Dose Edoxaban in Very Elderly Patients with Atrial Fibrillation","volume":"383","author":"Okumura","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.jacc.2019.01.011","article-title":"2019 AHA\/ACC\/HRS Focused Update of the 2014 AHA\/ACC\/HRS Guideline for the Management of Patients with Atrial Fibrillation","volume":"74","author":"January","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.jacc.2019.10.059","article-title":"Oral Anticoagulation for Patients with Atrial Fibrillation on Long-Term Hemodialysis","volume":"75","author":"Kuno","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1735","DOI":"10.1161\/CIRCULATIONAHA.121.054990","article-title":"Apixaban for Patients with Atrial Fibrillation on Hemodialysis: A Multicenter Randomized Controlled Trial","volume":"146","author":"Pokorney","year":"2022","journal-title":"Circulation"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1161\/CIRCULATIONAHA.122.062779","article-title":"A Randomized Controlled Trial Comparing Apixaban with the Vitamin K Antagonist Phenprocoumon in Patients on Chronic Hemodialysis: The AXADIA-AFNET 8 Study","volume":"147","author":"Reinecke","year":"2023","journal-title":"Circulation"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1474","DOI":"10.1681\/ASN.2020111566","article-title":"Safety and Efficacy of Vitamin K Antagonists versus Rivaroxaban in Hemodialysis Patients with Atrial Fibrillation: A Multicenter Randomized Controlled Trial","volume":"32","year":"2021","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Kelddal, S., Hvas, A.M., Grove, E.L., and Birn, H. (2022). Safety and Effectiveness of Direct Oral Anticoagulants in Patients with Nephrotic Syndrome: A Report of 21 Cases. BMC Nephrol., 23.","DOI":"10.1186\/s12882-022-02929-x"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e299","DOI":"10.1055\/a-1920-6224","article-title":"Apixaban Prophylactic Anticoagulation in Patients with Nephrotic Syndrome","volume":"6","author":"Cez","year":"2022","journal-title":"TH Open"},{"key":"ref_53","first-page":"169","article-title":"Direct Oral Anticoagulants in Nephrotic Syndrome: Our Experience and Literature Review","volume":"34","author":"Nissar","year":"2024","journal-title":"Indian J. Nephrol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1016\/j.ekir.2018.02.010","article-title":"Direct-Acting Oral Anticoagulants as Prophylaxis Against Thromboembolism in the Nephrotic Syndrome","volume":"3","author":"Sexton","year":"2018","journal-title":"Kidney Int. Rep."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1177\/10600280221129348","article-title":"Direct Oral Anticoagulants Versus Warfarin for Venous Thromboembolism Prophylaxis in Patients with Nephrotic Syndrome: A Retrospective Cohort Study","volume":"57","author":"Tijani","year":"2023","journal-title":"Ann. Pharmacother."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s12959-025-00685-0","article-title":"Direct Oral Anticoagulants Versus Warfarin for Venous Thromboembolism Prophylaxis in Nephrotic Syndrome Patients: A Retrospective Study","volume":"23","author":"Elshafei","year":"2025","journal-title":"Thromb. J."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"3053","DOI":"10.1016\/j.ekir.2024.07.013","article-title":"Anticoagulation for the Prevention of Thrombotic Events in Nephrotic Syndrome","volume":"9","author":"Azarniouch","year":"2024","journal-title":"Kidney Int. Rep."},{"key":"ref_58","first-page":"16739","article-title":"Primary Prevention of Venous Thromboembolism in Ambulatory Cancer Patients: Recent Advances and Practical Implications","volume":"134","author":"Harrigan","year":"2024","journal-title":"Pol. Arch. Intern. Med."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1959","DOI":"10.1182\/blood.2020007338","article-title":"Venous Thromboembolism in Cancer Patients: A Population-Based Cohort Study","volume":"137","author":"Mulder","year":"2021","journal-title":"Blood"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1056\/NEJMoa1814468","article-title":"Apixaban to Prevent Venous Thromboembolism in Patients with Cancer","volume":"380","author":"Carrier","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1160\/TH16-08-0615","article-title":"Cancer-Associated Venous Thromboembolism: Burden, Mechanisms, and Management","volume":"117","author":"Ay","year":"2017","journal-title":"Thromb. Haemost."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.1161\/ATVBAHA.120.314378","article-title":"Cancer Therapy-Associated Thrombosis","volume":"41","author":"Grover","year":"2021","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Fioretti, A.M., Scicchitano, P., La Forgia, D., De Luca, R., Campello, E., Tocchetti, C.G., Di Nisio, M., and Oliva, S. (2025). Prevention of Peripherally Inserted Central Catheter (PICC)-Associated Vein Thrombosis in Cancer: A Narrative Review. Biomedicines, 13.","DOI":"10.3390\/biomedicines13040786"},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Dorobantu-Lungu, L.R., Dinca, V., Gegiu, A., Spataru, D., Toma, A., Welt, L., Badea, M.F., Caruntu, C., Scheau, C., and Savulescu-Fiedler, I. (2025). The Relevance of the Virchow Node and Virchow Triad in Renal Cancer Diagnosis. Clin. Pract., 15.","DOI":"10.3390\/clinpract15010018"},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Hassan, N., Efing, J., Kiesel, L., Bendas, G., and G\u00f6tte, M. (2023). The Tissue Factor Pathway in Cancer: Overview and Role of Heparan Sulfate Proteoglycans. Cancers, 15.","DOI":"10.3390\/cancers15051524"},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Rudzi\u0144ska, M., Parodi, A., Soond, S.M., Vinarov, A.Z., Korolev, D.O., Morozov, A.O., Daglioglu, C., Tutar, Y., and Zamyatnin, A.A. (2019). The Role of Cysteine Cathepsins in Cancer Progression and Drug Resistance. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20143602"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"115027","DOI":"10.1016\/j.addr.2023.115027","article-title":"The Role of Coagulome in the Tumor Immune Microenvironment","volume":"200","author":"Wahab","year":"2023","journal-title":"Adv. Drug Deliv. Rev."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1002\/rth2.12266","article-title":"The Dual Role of Platelet\u2013Innate Immune Cell Interactions in Thrombo-Inflammation","volume":"4","author":"Rayes","year":"2019","journal-title":"Res. Pract. Thromb. Haemost."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Jaboury, S., Wang, K., O\u2019Sullivan, K.M., Ooi, J.D., and Ho, G.Y. (2023). NETosis as an Oncologic Therapeutic Target: A Mini Review. Front. Immunol., 14.","DOI":"10.3389\/fimmu.2023.1170603"},{"key":"ref_70","first-page":"28","article-title":"Targeting NETosis: Nature\u2019s Alarm System in Cancer Progression","volume":"7","author":"Liang","year":"2024","journal-title":"Cancer Drug Resist."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.2174\/1389450120666190715102510","article-title":"Recognition of Plasminogen Activator Inhibitor Type 1 as the Primary Regulator of Fibrinolysis","volume":"20","author":"Urano","year":"2019","journal-title":"Curr. Drug Targets"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"18945","DOI":"10.1038\/s41598-020-75863-3","article-title":"Efficacy and Safety of Direct Oral Anticoagulants for Secondary Prevention of Cancer-Associated Thrombosis: A Meta-Analysis of Randomized Controlled Trials","volume":"10","author":"Desai","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1056\/NEJMoa1711948","article-title":"Edoxaban for the Treatment of Cancer-Associated Venous Thromboembolism","volume":"378","author":"Raskob","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"2017","DOI":"10.1200\/JCO.2018.78.8034","article-title":"Comparison of an Oral Factor Xa Inhibitor with Low Molecular Weight Heparin in Patients with Cancer with Venous Thromboembolism: Results of a Randomized Trial (SELECT-D)","volume":"36","author":"Young","year":"2018","journal-title":"J. Clin. Oncol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1111\/jth.14662","article-title":"Apixaban and Dalteparin in Active Malignancy-Associated Venous Thromboembolism: The ADAM VTE Trial","volume":"18","author":"McBane","year":"2020","journal-title":"J. Thromb. Haemost."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.1056\/NEJMoa1915103","article-title":"Apixaban for the Treatment of Venous Thromboembolism Associated with Cancer","volume":"382","author":"Agnelli","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.jaccao.2023.10.009","article-title":"Comparing Anticoagulation Strategies for Venous Thromboembolism Associated with Active Cancer: A Systematic Review and Meta-Analysis","volume":"6","author":"Fujisaki","year":"2024","journal-title":"JACC CardioOncol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1891","DOI":"10.1111\/jth.14219","article-title":"Role of Direct Oral Anticoagulants in the Treatment of Cancer-Associated Venous Thromboembolism: Guidance from the SSC of the ISTH","volume":"16","author":"Khorana","year":"2018","journal-title":"J. Thromb. Haemost."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1200\/JCO.19.01461","article-title":"Venous Thromboembolism Prophylaxis and Treatment in Patients with Cancer: ASCO Clinical Practice Guideline Update","volume":"38","author":"Key","year":"2020","journal-title":"J. Clin. Oncol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"S128","DOI":"10.1016\/S0049-3848(10)70030-X","article-title":"The National Comprehensive Cancer Center Network (NCCN) Guidelines on the Management of Venous Thromboembolism in Cancer Patients","volume":"125","author":"Streiff","year":"2010","journal-title":"Thromb. Res."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1182\/bloodadvances.2020003442","article-title":"American Society of Hematology 2021 Guidelines for Management of Venous Thromboembolism: Prevention and Treatment in Patients with Cancer","volume":"5","author":"Lyman","year":"2021","journal-title":"Blood Adv."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"e16","DOI":"10.15420\/ecr.2022.63","article-title":"The 2022 European Society of Cardiology Cardio-Oncology Guidelines in Focus","volume":"18","author":"Gent","year":"2023","journal-title":"Eur. Cardiol."},{"key":"ref_83","unstructured":"World Obesity Atlas 2023 (2023, December 26). World Obesity Federation. Available online: https:\/\/www.worldobesity.org\/resources\/resource-library\/world-obesity-atlas-2023."},{"key":"ref_84","first-page":"162","article-title":"Association between Obesity and Venous Thromboembolism","volume":"93","author":"Hotoleanu","year":"2020","journal-title":"Med. Pharm. Rep."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1565","DOI":"10.1093\/eurheartj\/ehv486","article-title":"The Role of Obesity in Atrial Fibrillation","volume":"37","author":"Nalliah","year":"2016","journal-title":"Eur. Heart J."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.jacep.2015.04.004","article-title":"Obesity and the Risk of Incident, Post-Operative, and Post-Ablation Atrial Fibrillation: A Meta-Analysis of 626,603 Individuals in 51 Studies","volume":"1","author":"Wong","year":"2015","journal-title":"JACC Clin. Electrophysiol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"71","DOI":"10.2165\/11318100-000000000-00000","article-title":"Effect of Obesity on the Pharmacokinetics of Drugs in Humans","volume":"49","author":"Hanley","year":"2010","journal-title":"Clin. Pharmacokinet."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"e2044","DOI":"10.1002\/hsr2.2044","article-title":"Safety and Efficacy of Direct Oral Anticoagulants in Comparison to Warfarin in Obese Patients with Atrial Fibrillation: A Systematic Review and Meta-Analysis","volume":"7","author":"Adelkhanova","year":"2024","journal-title":"Health Sci. Rep."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"1874","DOI":"10.1111\/jth.15358","article-title":"Use of Direct Oral Anticoagulants in Patients with Obesity for Treatment and Prevention of Venous Thromboembolism: Updated Communication from the ISTH SSC Subcommittee on Control of Anticoagulation","volume":"19","author":"Martin","year":"2021","journal-title":"J. Thromb. Haemost."},{"key":"ref_90","first-page":"256","article-title":"Effect of Body Mass Index on the Efficacy and Safety of Direct Oral Anticoagulants: A Retrospective Cohort Study of the Veterans Affairs Population","volume":"39","author":"Coons","year":"2019","journal-title":"Pharmacotherapy"},{"key":"ref_91","doi-asserted-by":"crossref","unstructured":"Algethami, A., Ahmed, A.M.A., Ardah, H., Alsalamah, S., Alhabs, G., Al Fraihi, G., Alanazi, S., Alharbi, H., and Aljizeeri, A. (2025). Real-World Efficacy and Safety of Apixaban vs. Warfarin in Obese Atrial Fibrillation Patients: Propensity Matching Analysis. Biomedicines, 13.","DOI":"10.3390\/biomedicines13020490"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1007\/s40256-019-00362-4","article-title":"Efficacy and Safety of Direct Oral Anticoagulants Versus Warfarin in Patients with Atrial Fibrillation Across BMI Categories: A Systematic Review and Meta-Analysis","volume":"20","author":"Zhou","year":"2020","journal-title":"Am. J. Cardiovasc. Drugs"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC Guidelines for the Diagnosis and Management of Atrial Fibrillation Developed in Collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the Diagnosis and Management of Atrial Fibrillation of the European Society of Cardiology (ESC)","volume":"42","author":"Hindricks","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_94","first-page":"10","article-title":"Direct-Acting Oral Anticoagulants in Patients at Extremes of Body Weight: A Review of Pharmacological Considerations and Clinical Implications","volume":"22","author":"Talerico","year":"2024","journal-title":"J. Thromb. Haemost."},{"key":"ref_95","first-page":"272","article-title":"Use of Direct Oral Anticoagulants in Morbidly Obese Patients","volume":"39","author":"Kido","year":"2019","journal-title":"Pharmacotherapy"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1093\/ajhp\/zxaa059","article-title":"Direct-Acting Oral Anticoagulant Use at Extremes of Body Weight: Literature Review and Recommendations","volume":"77","author":"Covert","year":"2020","journal-title":"Am. J. Health Syst. Pharm."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1136\/annrheumdis-2019-215213","article-title":"EULAR Recommendations for the Management of Antiphospholipid Syndrome in Adults","volume":"78","author":"Tektonidou","year":"2019","journal-title":"Ann. Rheum. Dis."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.jacc.2022.10.008","article-title":"Direct Oral Anticoagulants vs. Vitamin K Antagonists in Patients with Antiphospholipid Syndromes: Meta-Analysis of Randomized Trials","volume":"81","author":"Khairani","year":"2023","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1182\/blood-2018-04-848333","article-title":"Rivaroxaban vs. Warfarin in High-Risk Patients with Antiphospholipid Syndrome","volume":"132","author":"Pengo","year":"2018","journal-title":"Blood"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"685","DOI":"10.7326\/M19-0291","article-title":"Rivaroxaban Versus Vitamin K Antagonist in Antiphospholipid Syndrome: A Randomized Noninferiority Trial","volume":"171","author":"Vidal","year":"2019","journal-title":"Ann. Intern. Med."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"715878","DOI":"10.3389\/fcvm.2021.715878","article-title":"Use of Direct Oral Anticoagulants in Patients with Antiphospholipid Syndrome: A Systematic Review and Comparison of the International Guidelines","volume":"8","author":"Pastori","year":"2021","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"2126","DOI":"10.1111\/jth.14935","article-title":"Use of Direct Oral Anticoagulants in Patients with Thrombotic Antiphospholipid Syndrome: Guidance from the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis","volume":"18","author":"Zuily","year":"2020","journal-title":"J. Thromb. Haemost."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1111\/bjh.16308","article-title":"Addendum to British Society for Haematology Guidelines on Investigation and Management of Antiphospholipid Syndrome, 2012: Use of Direct-Acting Oral Anticoagulants","volume":"189","author":"Arachchillage","year":"2020","journal-title":"Br. J. Haematol."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"4693","DOI":"10.1182\/bloodadvances.2020001830","article-title":"American Society of Hematology 2020 Guidelines for Management of Venous Thromboembolism: Treatment of Deep Vein Thrombosis and Pulmonary Embolism","volume":"4","author":"Ortel","year":"2020","journal-title":"Blood Adv."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1161\/STROKEAHA.116.016414","article-title":"Embolic Stroke of Undetermined Source: A Systematic Review and Clinical Update","volume":"48","author":"Hart","year":"2017","journal-title":"Stroke"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1001\/jamaneurol.2024.4847","article-title":"Anticoagulation in ESUS\u2014Back from the Dead?","volume":"82","author":"Elser","year":"2025","journal-title":"JAMA Neurol."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"1906","DOI":"10.1056\/NEJMoa1813959","article-title":"Dabigatran for Prevention of Stroke after Embolic Stroke of Undetermined Source","volume":"380","author":"Diener","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_108","first-page":"EVIDoa2300235","article-title":"Apixaban versus Aspirin for Embolic Stroke of Undetermined Source","volume":"3","author":"Geisler","year":"2024","journal-title":"NEJM Evid."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"e209949","DOI":"10.1212\/WNL.0000000000209949","article-title":"Anticoagulation vs. Antiplatelets Across Subgroups of Embolic Stroke of Undetermined Source: A Meta-Analysis of Randomized Controlled Trials","volume":"103","author":"Ghannam","year":"2024","journal-title":"Neurology"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"2715","DOI":"10.1161\/STROKEAHA.121.035208","article-title":"Reexamination of the Embolic Stroke of Undetermined Source Concept","volume":"52","author":"Albers","year":"2021","journal-title":"Stroke"},{"key":"ref_111","doi-asserted-by":"crossref","unstructured":"Mangiafico, M., and Costanzo, L. (2024). Superficial Venous Thrombosis: A Comprehensive Review. Healthcare, 12.","DOI":"10.3390\/healthcare12040500"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"25S","DOI":"10.1016\/j.jvs.2007.08.037","article-title":"Acute Venous Disease: Venous Thrombosis and Venous Trauma","volume":"46","author":"Meissner","year":"2007","journal-title":"J. Vasc. Surg."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1177\/1076029618779143","article-title":"The Prevalence of Concomitant Deep Vein Thrombosis, Symptomatic or Asymptomatic, Proximal or Distal, in Patients with Symptomatic Pulmonary Embolism","volume":"24","author":"Hirmerova","year":"2018","journal-title":"Clin. Appl. Thromb. Hemost."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"e105","DOI":"10.1016\/S2352-3026(17)30014-5","article-title":"Prevention of Thromboembolic Complications in Patients with Superficial-Vein Thrombosis Given Rivaroxaban or Fondaparinux: The Open-Label, Randomised, Non-Inferiority SURPRISE Phase 3b Trial","volume":"4","author":"Schellong","year":"2017","journal-title":"Lancet Haematol."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1055\/s-0040-1718891","article-title":"Rivaroxaban Compared to Placebo for the Treatment of Leg Superficial Vein Thrombosis: A Randomized Trial. Semin","volume":"46","author":"Kearon","year":"2020","journal-title":"Thromb. Hemost."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.chest.2015.11.026","article-title":"Antithrombotic Therapy for VTE Disease: CHEST Guideline and Expert Panel Report","volume":"149","author":"Kearon","year":"2016","journal-title":"Chest"},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1002\/rth2.12480","article-title":"Direct Oral Anticoagulants for Unusual-Site Venous Thromboembolism","volume":"5","author":"Riva","year":"2021","journal-title":"Res. Pract. Thromb. Haemost."},{"key":"ref_118","doi-asserted-by":"crossref","unstructured":"Di Nisio, M., Camporese, G., Di Micco, P., Martini, R., Ageno, W., and Prandoni, P. (2024). Treatment of Superficial Vein Thrombosis: Recent Advances, Unmet Needs and Future Directions. Healthcare, 12.","DOI":"10.20944\/preprints202406.1330.v1"},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.ejim.2024.01.017","article-title":"Treatment with Direct Oral Anticoagulants (DOACs) and Secondary Prophylaxis in Patients Affected by Multiple Episodes of Superficial Venous Thrombosis","volume":"122","author":"Sorella","year":"2024","journal-title":"Eur. J. Intern. Med."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1161\/01.CIR.0000142289.94369.D7","article-title":"Upper-Extremity Deep Vein Thrombosis: A Prospective Registry of 592 Patients","volume":"110","author":"Joffe","year":"2004","journal-title":"Circulation"},{"key":"ref_121","unstructured":"Grigorian, A., and Nahmias, J.T. (2023, January 30). Upper Extremity Deep Venous Thrombosis, StatPearls [Internet], Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK482420\/."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1007\/s11239-020-02044-4","article-title":"Upper Extremity Deep Vein Thrombosis Treated with Direct Oral Anticoagulants: A Multi-Center Real World Experience","volume":"50","author":"Porfidia","year":"2020","journal-title":"J. Thromb. Thrombolysis"},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.ijcard.2021.07.005","article-title":"Upper Extremities Deep Vein Thrombosis Treated with Oral Direct Anticoagulants: A Prospective Cohort Study","volume":"339","author":"Vedovati","year":"2021","journal-title":"Int. J. Cardiol."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1002\/ajh.25820","article-title":"Treatment of upper extremity deep vein thrombosis with apixaban and rivaroxaban","volume":"95","author":"Houghton","year":"2020","journal-title":"Am. J. Hematol."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"e119","DOI":"10.1055\/s-0040-1713683","article-title":"Effectiveness and Safety of Apixaban for Treatment of Venous Thromboembolism in Daily Practice","volume":"4","author":"Hendriks","year":"2020","journal-title":"TH Open"},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1093\/eurheartj\/ehz405","article-title":"2019 ESC Guidelines for the Diagnosis and Management of Acute Pulmonary Embolism Developed in Collaboration with the European Respiratory Society (ERS)","volume":"41","author":"Konstantinides","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.ejvs.2021.10.054","article-title":"Editor\u2019s Choice\u2014Severe Bleeding Risks of Direct Oral Anticoagulants in the Prevention and Treatment of Venous Thromboembolism: A Network Meta-Analysis of Randomised Controlled Trials","volume":"63","author":"Chen","year":"2022","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1016\/j.thromres.2020.08.016","article-title":"Drug-drug interactions with direct oral anticoagulants associated with adverse events in the real world: A systematic review","volume":"194","author":"Li","year":"2020","journal-title":"Thromb. Res."},{"key":"ref_129","unstructured":"Hollingsworth, C.M., and Mead, T. (2023, August 20). Inferior Vena Caval Thrombosis, StatPearls [Internet], Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK537175\/."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.thromres.2016.07.010","article-title":"Etiology and Treatment of Acute Inferior Vena Cava Thrombosis","volume":"149","author":"Shi","year":"2017","journal-title":"Thromb. Res."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"bcr2013009627","DOI":"10.1136\/bcr-2013-009627","article-title":"Inferior Vena Cava Thrombosis","volume":"2013","author":"Qureshi","year":"2013","journal-title":"BMJ Case Rep."},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1016\/j.thromres.2014.07.012","article-title":"Thrombosis of the inferior vena cava and malignant disease","volume":"134","author":"Kraft","year":"2014","journal-title":"Thromb. Res."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1177\/1358863X12471967","article-title":"Inferior vena cava thrombosis: A review of current practice","volume":"18","author":"McAree","year":"2013","journal-title":"Vasc. Med."},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1111\/ejh.14097","article-title":"Direct oral anticoagulants versus warfarin for the treatment of inferior vena cava thrombus","volume":"111","author":"Mihm","year":"2023","journal-title":"Eur. J. Haematol."},{"key":"ref_135","first-page":"456","article-title":"Bleeding Risks Associated with DOACs vs VKAs in IVC Thrombosis","volume":"19","author":"Carrier","year":"2022","journal-title":"J. Thromb. Haemost."},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1177\/02683555241256264","article-title":"Pelvic Vein Thrombosis in Patients with Pelvic Venous Disorders","volume":"39","author":"Gavrilov","year":"2024","journal-title":"Phlebology"},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1002\/ijgo.12944","article-title":"Direct Oral Anticoagulants Are Effective and Safe for the Treatment of Venous Thromboembolism Associated with Gynecological Cancers","volume":"147","author":"Shimizu","year":"2019","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1161\/STROKEAHA.121.037541","article-title":"Direct Oral Anticoagulants Versus Warfarin in the Treatment of Cerebral Venous Thrombosis (ACTION-CVT): A Multicenter International Study","volume":"53","author":"Yaghi","year":"2022","journal-title":"Stroke"},{"key":"ref_139","doi-asserted-by":"crossref","first-page":"3014","DOI":"10.1161\/STROKEAHA.122.039579","article-title":"Direct Oral Anticoagulants Versus Vitamin K Antagonists in Cerebral Venous Thrombosis: A Systematic Review and Meta-Analysis","volume":"53","author":"Yaghi","year":"2022","journal-title":"Stroke"},{"key":"ref_140","first-page":"101","article-title":"Venous Thromboembolism in Patients with COVID-19 Infection: Risk Factors, Prevention, and Management. Semin","volume":"34","author":"Ahuja","year":"2021","journal-title":"Vasc. Surg."},{"key":"ref_141","doi-asserted-by":"crossref","first-page":"287","DOI":"10.3325\/cmj.2022.63.287","article-title":"The Role of Direct Oral Anticoagulants in the Era of COVID-19: Are Antiviral Therapy and Pharmacogenetics Limiting Factors?","volume":"63","author":"Kuna","year":"2022","journal-title":"Croat. Med. J."},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"785738","DOI":"10.3389\/fcvm.2021.785738","article-title":"Fundamentals in COVID-19-Associated Thrombosis: Molecular and Cellular Aspects","volume":"8","author":"Mizurini","year":"2021","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_143","doi-asserted-by":"crossref","first-page":"100117","DOI":"10.1016\/j.tru.2022.100117","article-title":"The Interplay between Inflammation and Thrombosis in COVID-19: Mechanisms, Therapeutic Strategies, and Challenges","volume":"8","author":"Ma","year":"2022","journal-title":"Thromb. Update"},{"key":"ref_144","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.1001\/jama.2021.17272","article-title":"ACTIV-4B Investigators. Effect of Antithrombotic Therapy on Clinical Outcomes in Outpatients with Clinically Stable Symptomatic COVID-19: The ACTIV-4B Randomized Clinical Trial","volume":"326","author":"Connors","year":"2021","journal-title":"JAMA"},{"key":"ref_145","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/S0140-6736(21)02392-8","article-title":"Rivaroxaban versus No Anticoagulation for Post-Discharge Thromboprophylaxis after Hospitalisation for COVID-19 (MICHELLE): An Open-Label, Multicentre, Randomised, Controlled Trial","volume":"399","author":"Ramacciotti","year":"2022","journal-title":"Lancet"},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"1844","DOI":"10.1093\/europace\/euac020","article-title":"Assessment and Mitigation of Bleeding Risk in Atrial Fibrillation and Venous Thromboembolism: A Position Paper from the ESC Working Group on Thrombosis, in Collaboration with the European Heart Rhythm Association, the Association for Acute CardioVascular Care and the Asia-Pacific Heart Rhythm Society","volume":"24","author":"Gorog","year":"2022","journal-title":"Europace"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/9\/2914\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:20:17Z","timestamp":1760030417000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/9\/2914"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,23]]},"references-count":146,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["jcm14092914"],"URL":"https:\/\/doi.org\/10.3390\/jcm14092914","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,23]]}}}