201. Hirudin therapy during thrombolysis for venous thrombosis in heparin-induced thrombocytopenia.
- Author
-
Reilly MP, Weiss R, Askenase A, Tuite C, Soulen M, and Mohler ER 3rd
- Subjects
- Humans, Male, Middle Aged, Phlebography, Thrombocytopenia diagnostic imaging, Treatment Outcome, Venous Thrombosis diagnostic imaging, Venous Thrombosis etiology, Anticoagulants therapeutic use, Heparin adverse effects, Hirudin Therapy, Hirudins analogs & derivatives, Recombinant Proteins therapeutic use, Thrombocytopenia chemically induced, Thrombolytic Therapy methods, Venous Thrombosis drug therapy
- Abstract
Heparin-induced thrombocytopenia (HIT) is the most common drug-related thrombocytopenia. Thromboembolic complications occur in approximately 50% of patients with HIT and result in limb amputation and death in up to 20% and 30% respectively. Because patients with a history of HIT may require future intravenous anticoagulation but have a high-risk of thromboembolism if re-challenged with heparin, alternative therapies are necessary when further anticoagulation is indicated. The use of direct thrombin inhibitors in HIT patients who also require thrombolytic therapy offers unique challenges to anticoagulant monitoring and safety. We present a case of progressive ileofemoral deep venous thrombosis in a patient with a history of HIT in order to review the combined use of hirudin and thrombolysis in this setting.
- Published
- 2000