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Recent Myocardial Infarction and Acute Heparin-Induced Thrombocytopenia: A Case Report on Perioperative Management of a Patient for Acute Limb Vascular Surgery

The optimal alternative anticoagulation regimen for patients with heparin-induced thrombocytopenia (HIT) who need surgical procedures that involve higher levels of anticoagulation, usually performed under heparin, is not yet established. Argatroban has been reported as a safe alternative. Plasma lev...

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Detalles Bibliográficos
Autores principales: Nogueira, Sara, Queijo, Joana, Teles, Ana Rita
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9701080/
https://www.ncbi.nlm.nih.gov/pubmed/36447732
http://dx.doi.org/10.7759/cureus.30763
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author Nogueira, Sara
Queijo, Joana
Teles, Ana Rita
author_facet Nogueira, Sara
Queijo, Joana
Teles, Ana Rita
author_sort Nogueira, Sara
collection PubMed
description The optimal alternative anticoagulation regimen for patients with heparin-induced thrombocytopenia (HIT) who need surgical procedures that involve higher levels of anticoagulation, usually performed under heparin, is not yet established. Argatroban has been reported as a safe alternative. Plasma levels and their anticoagulant effects follow a predictable profile. Also, it is easily monitored and its pharmacokinetic profile makes it suitable for patients with renal failure, as it undergoes hepatic elimination. However, its use as a substitute for heparin in HIT patients is not well-documented, especially in vascular surgery. We present a case of a successfully managed patient with acute HIT undergoing limb vascular surgery using anticoagulation with argatroban.
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spelling pubmed-97010802022-11-28 Recent Myocardial Infarction and Acute Heparin-Induced Thrombocytopenia: A Case Report on Perioperative Management of a Patient for Acute Limb Vascular Surgery Nogueira, Sara Queijo, Joana Teles, Ana Rita Cureus Anesthesiology The optimal alternative anticoagulation regimen for patients with heparin-induced thrombocytopenia (HIT) who need surgical procedures that involve higher levels of anticoagulation, usually performed under heparin, is not yet established. Argatroban has been reported as a safe alternative. Plasma levels and their anticoagulant effects follow a predictable profile. Also, it is easily monitored and its pharmacokinetic profile makes it suitable for patients with renal failure, as it undergoes hepatic elimination. However, its use as a substitute for heparin in HIT patients is not well-documented, especially in vascular surgery. We present a case of a successfully managed patient with acute HIT undergoing limb vascular surgery using anticoagulation with argatroban. Cureus 2022-10-27 /pmc/articles/PMC9701080/ /pubmed/36447732 http://dx.doi.org/10.7759/cureus.30763 Text en Copyright © 2022, Nogueira et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Anesthesiology
Nogueira, Sara
Queijo, Joana
Teles, Ana Rita
Recent Myocardial Infarction and Acute Heparin-Induced Thrombocytopenia: A Case Report on Perioperative Management of a Patient for Acute Limb Vascular Surgery
title Recent Myocardial Infarction and Acute Heparin-Induced Thrombocytopenia: A Case Report on Perioperative Management of a Patient for Acute Limb Vascular Surgery
title_full Recent Myocardial Infarction and Acute Heparin-Induced Thrombocytopenia: A Case Report on Perioperative Management of a Patient for Acute Limb Vascular Surgery
title_fullStr Recent Myocardial Infarction and Acute Heparin-Induced Thrombocytopenia: A Case Report on Perioperative Management of a Patient for Acute Limb Vascular Surgery
title_full_unstemmed Recent Myocardial Infarction and Acute Heparin-Induced Thrombocytopenia: A Case Report on Perioperative Management of a Patient for Acute Limb Vascular Surgery
title_short Recent Myocardial Infarction and Acute Heparin-Induced Thrombocytopenia: A Case Report on Perioperative Management of a Patient for Acute Limb Vascular Surgery
title_sort recent myocardial infarction and acute heparin-induced thrombocytopenia: a case report on perioperative management of a patient for acute limb vascular surgery
topic Anesthesiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9701080/
https://www.ncbi.nlm.nih.gov/pubmed/36447732
http://dx.doi.org/10.7759/cureus.30763
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