Warfarin: Lack of efficacy.

A 41-year-old woman with multiple medical conditions, including antiphospholipid syndrome, recurrent pulmonary embolism, and deep vein thrombosis, experienced a lack of efficacy during anticoagulant therapy with warfarin. Despite undergoing suction thrombectomy to remove multiple small chronic clots, a large saddle embolus remained. The woman was discharged on warfarin but presented again with acute respiratory failure a month later. A CT angiogram revealed that the large saddle embolism was still present, indicating a lack of efficacy to warfarin. Although advised for mechanical thrombectomy, the woman and her family declined surgery and she continued on warfarin. [Extracted from the article]