scholarly journals Transcatheter embolization of the marginal artery of drummond as treatment for life-threatening retroperitoneal hemorrhage complicating heparin therapy

1994 ◽  
Vol 17 (3) ◽  
Author(s):  
InW. Choo ◽  
IanA. Sproat ◽  
KyungJ. Cho
Keyword(s):  
Transcatheter Embolization ◽  
Heparin Therapy ◽  
Retroperitoneal Hemorrhage ◽  
Marginal Artery ◽  
Life Threatening ◽  
Marginal Artery Of Drummond

Safety and Efficacy of Argatroban in the Management of Heparin-Induced Thrombocytopenia

2011 ◽  
Vol 4 ◽  
pp. CMBD.S5118 ◽  
Author(s):  
Bernd Saugel ◽  
Roland M. Schmid ◽  
Wolfgang Huber
Keyword(s):  
Arterial Thrombosis ◽  
Pharmacokinetic Profile ◽  
The United States ◽  
Heparin Therapy ◽  
Direct Thrombin Inhibitor ◽  
Thrombin Inhibitor ◽  
Heparin Induced Thrombocytopenia ◽  
Safety And Efficacy ◽  
Increased Risk ◽  
Life Threatening

Heparin-induced thrombocytopenia (HIT) is a life-threatening adverse reaction to heparin therapy that is characterized by thrombocytopenia and an increased risk of venous and arterial thrombosis. According to guidelines, in patients with strongly suspected or confirmed HIT all sources of heparin have to be discontinued and an alternative, nonheparin anticoagulant for HIT treatment must immediately be started. For both the prophylaxis of thrombembolic events in HIT and the treatment of HIT with thrombosis the direct thrombin inhibitor argatroban is approved in the United States. The objective of this review is to describe the mechanism of action and the pharmacokinetic profile of argatroban, to characterize argatroban regarding its safety and therapeutic efficacy and to discuss its place in therapy in HIT.

Diagnosis and treatment of heparin-induced thrombocytopenia

Perfusion ◽  
2003 ◽  
Vol 18 (1) ◽  
pp. 47-53 ◽  
Author(s):  
William J DeBois ◽  
Junli Liu ◽  
Leonard Y Lee ◽  
Leonard N Girardi ◽  
Charles Mack ◽  
...  
Keyword(s):  
New York ◽  
Platelet Inhibition ◽  
Heparin Therapy ◽  
Serotonin Release ◽  
Antibody Detection ◽  
Thrombin Inhibitor ◽  
Heparin Infusion ◽  
Platelet Factor ◽  
Heparin Induced Thrombocytopenia ◽  
Life Threatening

Heparin-induced thrombocytopenia (HIT) is a major side effect secondary to the administration of heparin. This syndrome is serious and potentially life threatening. This response is the result of antibodies formed against the platelet factor 4 (PF4)/heparin complex. The incidence of this immune-mediated syndrome has been estimated to be 1-3% of all patients receiving heparin therapy. The occurrence of HIT in patients requiring full anticoagulation for cardiopulmonary bypass (CPB), therefore, presents a serious challenge to the cardiac surgery team. The diagnosis of HIT should be based on both clinical and laboratory evidence. While functional assays, platelet aggregation tests, and the serotonin release assay can be used to support the diagnosis, the negative predictive value of these tests is generally less than 50%. In contrast, although non-functional antibody detection assays are more sensitive, they have a low specificity. HIT can be treated in several ways, including cessation of all heparin and giving an alternative thrombin inhibitor, platelet inhibition followed by heparin infusion, and the use of low molecular weight heparins. In this presentation, the pathology and current diagnostic tests, as well as the successful management of patients with HIT undergoing CPB at New York Presbyterian Hospital, are reviewed.

scholarly journals Retroperitoneal Hematoma Following Enoxaparin Treatment in an Elderly Woman - A Case Report

1970 ◽  
Vol 3 (1) ◽  
pp. 94-97 ◽  
Author(s):  
MM Haq ◽  
SDM Taimur ◽  
SR Khan ◽  
MA Rahman
Keyword(s):  
Acute Coronary Syndrome ◽  
Fatal Outcome ◽  
Anticoagulation Therapy ◽  
Retroperitoneal Hematoma ◽  
Low Molecular Weight ◽  
Retroperitoneal Hemorrhage ◽  
Coronary Syndrome ◽  
Anticoagulation Treatment ◽  
Life Threatening ◽  
Arterial Aneurysms

Retroperitoneal hematoma may occur as a result of trauma, rupture of arterial aneurysms (aortic or iliac), surgical complications, tumors and anticoagulation therapy. A life threatening retroperitoneal hemorrhage or hematoma is an infrequent complication of anticoagulation treatment. Enoxaparin is a low-molecular-weight heparin (LMWH) with several advantages over unfractionated heparin. Nevertheless, enoxaparin use is not without risk and severe retroperitoneal bleeding may occur following its use with a potentially fatal outcome. We report a case of sixty six years old female patient who develops a fatal retroperitoneal hematoma two days after enoxaparin treatment for acute coronary syndrome. Keywords: Retroperitoneal hematoma; Enoxaparin; Acute coronary syndrome. DOI: 10.3329/cardio.v3i1.6434Cardiovasc. j. 2010; 3(1): 94-97

scholarly journals Use of Edoxaban for the Treatment of Heparin-Induced Thrombocytopenia

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Ryo Kanamoto ◽  
Shinichi Hiromatsu ◽  
Tomoyuki Anegawa ◽  
Kanako Sakurai ◽  
Shohei Yoshida ◽  
...  
Keyword(s):  
Adverse Drug Reaction ◽  
Esophageal Cancer ◽  
Oral Treatment ◽  
Length Of Hospital Stay ◽  
Heparin Therapy ◽  
Vitamin K Antagonist ◽  
Bleeding Complications ◽  
Heparin Induced Thrombocytopenia ◽  
Life Threatening

Heparin-induced thrombocytopenia (HIT) is a life-threatening adverse drug reaction of heparin therapy, which increases a patient’s risk of developing venous and/or arterial thromboembolism. HIT should be treated through discontinuation of heparin and administration of nonheparin anticoagulants such as argatroban. For long-term anticoagulation, parenteral nonheparin anticoagulants are generally converted to oral treatment with a vitamin K antagonist such as warfarin. Although administration of warfarin is recommended to overlap with a nonheparin anticoagulant for a minimum of 5 days, overlapping with argatroban and warfarin presents high risks of bleeding. We describe a case of HIT treated with edoxaban. A 78-year-old man underwent surgery for esophageal cancer and was administered heparin perioperatively. After surgery, he was diagnosed with HIT and venous thromboembolism. We immediately stopped heparin and initiated parenteral argatroban. The patient was subsequently started on edoxaban without any overlap between the two drugs. The treatment was successful. The treatment of edoxaban following argatroban for HIT could reduce bleeding complications and shorten the length of hospital stay. To the best of our knowledge, this is the first report of the use of edoxaban for HIT treatment.

Thrombocytopenia Is More Common and Nadir Occurs Earlier with Unfractionated Heparin Than with Low Molecular Weight Heparin - Results from the Prospective Catch Registry.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2197-2197
Author(s):  
Stephan Moll ◽  
Charles S. Abrams ◽  
Lawrence Rice ◽  
Richard C. Becker ◽  
Peter B. Berger ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Platelet Count ◽  
Unfractionated Heparin ◽  
Low Molecular Weight Heparin ◽  
Heparin Therapy ◽  
P Value ◽  
Low Molecular Weight ◽  
Life Threatening ◽  
The Difference ◽  
Time To Onset

Abstract Background : Thrombocytopenia in the patient on heparin can have various etiologies, including benign reversible causes and serious, potentially life-threatening ones, such as heparin induced thrombocytopenia (HIT). Knowledge about the prevalence of and timecourse of thrombocytopenia in heparin-treated patients may be helpful to develop systems of alerting clinicians to possible HIT and determining how frequently to check blood counts to detect thrombocytopenia that may be heralding HIT. Methods : The CATCH registry is a prospective registry of inpatients enrolled between March 2003 and April 2004 at over 50 US hospitals in 3 strata: [1] receiving > 96 hours of unfractionated heparin (UFH) or low molecular weight heparin (LMWH), [2] developing thrombocytopenia (platelets >50% reduction from baseline or <150,000/mm3) in the cardiac care unit and [3] patients on whom HIT tests were ordered. Here we present the data of the prolonged heparin stratum. Results : 1,121 and 861 patients received UFH and LMWH, respectively, for > 96 hours. A platelet count decrease of > 50 % from baseline was seen more frequently in patients on UFH than in patients on LMWH (10.7% and 7.9 %, respectively; p = 0.03). The parameters that predicted development of thrombocytopenia in the UHF group were length of heparin therapy, body mass index, and admission to a cardiac service; the only parameter predicting thrombocytopenia in the LMWH group was length of LMWH treatment. Of the patients with decreased platelet count by > 50 % from baseline (for UFH n = 120; for LMWH n = 68), this drop occurred in the UFH group at a median of 3.0 days after initiation of heparin and at a median of 4.0 days in the LMWH group. The difference in timing between the 2 groups was not statistically significant (p = 0.205). The platelet nadir was reached after a median /mean of 4.0 / 7.4 days in the UFH group, and 8.0 / 11.4 days in the LMWH group. This was statistically significantly different between the 2 groups (p-value = 0.0025). Conclusions : A platelet count decrease of > 50 % from baseline occurs frequently in inpatients treated with prolonged heparin. It occurs slightly more frequently on UFH than on LMWH. The median time to onset of thrombocytopenia (> 50 % decrease from baseline) occurs early, at 3–4 days. Daily platelet count checks in the first few days of heparin therapy may be helpful to rapidly discover thrombocytopenia that may then prompt HIT testing.

scholarly journals Marginal artery of Drummond

2008 ◽  
Author(s):  
Craig Hacking ◽  
Donna D'Souza
Keyword(s):  
Marginal Artery ◽  
Marginal Artery Of Drummond

scholarly journals Life-Threatening Retroperitoneal Hematoma in a Patient with COVID-19

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Monarch Shah ◽  
John Paul Colombo ◽  
Sanya Chandna ◽  
Haris Rana
Keyword(s):  
Respiratory Illness ◽  
Suspected Case ◽  
Retroperitoneal Hemorrhage ◽  
Active Monitoring ◽  
Safety And Efficacy ◽  
Optimal Dosing ◽  
Therapeutic Anticoagulation ◽  
Hemorrhagic Complications ◽  
Life Threatening ◽  
Risk Of Hemorrhage

COVID-19 is a respiratory illness that affects the human body in many different ways. The disease carries both thrombotic and hemorrhagic complications, especially in those patients who are anticoagulated to prevent the thromboembolic manifestations. In this report, we discuss a case of retroperitoneal hemorrhage in a patient treated with therapeutic anticoagulation which ultimately led to the patient’s death. The literature highlights the importance of anticoagulation because it reduces mortality in patients hospitalized with COVID-19. Although, more recent studies suggest that patients treated with therapeutic anticoagulation are at a higher risk of hemorrhage and increased mortality. Therefore, our case stresses the importance of active monitoring of these patients to detect any suspected case of hemorrhage early to reduce mortality. Overall, more research should be conducted to determine the optimal dosing of anticoagulation that balances safety and efficacy.

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