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Recurrent venous thromboembolism after discontinuation of rivaroxaban therapy in a patient with antiphospholipid syndrome
  1. Shusuke Yagi1,2,3,
  2. Seiichi Nishiyama1,
  3. Toshio Abe1 and
  4. Masataka Sata2
  1. 1 Shikoku Central Hospital, Shikoku-chuo, Ehime, Japan
  2. 2 Department of Cardiovascular Medicine, Tokushima University Graduate School of BiomedicalSciences, Tokushima, Japan
  3. 3 Department of Community Medicine and Human ResourceDevelopment, Tokushima University Graduate School of BiomedicalSciences, Tokushima, Japan
  1. Correspondence to Dr Shusuke Yagi, syagi{at}


Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterised by thromboembolic events including venous thromboembolism (VTE) in association with the presence of antiphospholipid antibodies. The standard treatment of VTE historically consists of anticoagulation therapy with warfarin, a vitamin K antagonist. Recently, direct oral anticoagulants, including rivaroxaban have become available for the treatment of VTE. However, the choice of anticoagulant, and the duration of anticoagulation in patients with APS has not been determined yet due to lack of evidence. Here, we report a case of recurrent venous thrombosis after discontinuation of rivaroxaban therapy and avoiding sedentary lifestyle in a patient with APS. We suggest that indefinite anticoagulation therapy might be needed even in low-risk APS cases.

  • cardiovascular medicine
  • venous thromboembolism

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  • Contributors SY, SN managed the patietnt. TA performed imaging studies. MS supervised the treatment.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.