A Case of Posterior Circulation Ischemic Stroke Caused by Heparin-Induced Thrombocytopenia after Detaining Hepatic Arterial Infusion Catheter

Hirashita, Koji; Matsumoto, Atsushi; Yabuno, Satoru; Kanda, Takahiro; Yunoki, Masatoshi; Yoshino, Katsumi

doi:10.1016/j.jstrokecerebrovasdis.2018.04.011

Cited by 8 publications

(6 citation statements)

References 11 publications

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“…The application of blood-contacting implantable/interventional devices (e.g., artificial hearts, ventricular assist devices, pacemakers, central venous catheters) and extracorporeal medical devices consisting of external circuits and indwelling catheters have saved millions of people’s lives. , However, it poses the risk of the three major clinical complications of inflammation, thrombosis, and infection, which substantially contribute to device failure, patient morbidity, mortality, and increased healthcare costs. , To solve these problems, drug therapies using anticoagulant drugs, such as heparin, and antibiotics are common clinical means. Unfortunately, such a systemic administration of drugs involved high risks of hemorrhage and heparin-induced thrombocytopenia (HIT-II) in the patients and, on the side of the bacteria, the development of antibiotic resistance. , Worse yet, antibiotics may cause other serious adverse effects such as epidermal necrolysis, fever, thrombophlebitis, and even hypersensitivity syndrome, noted as red man syndrome, which are even worse than the infection itself . The clinical data have revealed that most drug-related deaths from adverse clinical events are ascribed to the systemic administration of anticoagulant or antibiotic drugs. , …”

Section: Introductionmentioning

confidence: 99%

“…Unfortunately, such a systemic administration of drugs involved high risks of hemorrhage and heparin-induced thrombocytopenia (HIT-II) in the patients and, on the side of the bacteria, the development of antibiotic resistance. 5,6 Worse yet, antibiotics may cause other serious adverse effects such as epidermal necrolysis, fever, thrombophlebitis, and even hypersensitivity syndrome, noted as red man syndrome, which are even worse than the infection itself. 7 The clinical data have revealed that most drug-related deaths from adverse clinical events are ascribed to the systemic administration of anticoagulant or antibiotic drugs.…”

Section: Introductionmentioning

confidence: 99%

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Assembly of Metal–Phenolic/Catecholamine Networks for Synergistically Anti-Inflammatory, Antimicrobial, and Anticoagulant Coatings

Gao

Tan

et al. 2018

ACS Appl. Mater. Interfaces

133

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The development of a facile and versatile strategy to endow surfaces with synergistically anti-inflammatory, antimicrobial, and anticoagulant functions is of particular significance for blood-contacting biomaterials and medical devices. In this work, we report a simple and environmentally friendly "one-pot" method inspired by byssal cuticle chemistry, namely, [Fe(dopa) 3 ] coordination chemistry for assembly of copper ions (Cu 2+ ) and plant polyphenol (tannic acid)/ catecholamine (dopamine or norepinephrine) to form metal− phenolic/catecholamine network-based coatings. This one-pot method enabled us to easily develop a multifunctional surface based on the combination of the characteristic functions of metal ions and plant polyphenol or catecholamine. The residual phenolic hydroxyl groups on the coatings imparted the modified surface with excellent antioxidant and anti-inflammatory functions. The robust chelation of copper ions to the metal− phenolic/catecholamine networks provided not only durable antibacterial property but also glutathione peroxidase like catalytic capability to continuously and controllably produce antithrombotic nitric oxide by catalyzing endogenous S-nitrothiol. The biological functions of such coatings could be well regulated by adjusting the ratios of the feed concentration of Cu 2+ ions to plant polyphenol or catecholamine. We envision that our simple, multifunctional, and bioinspired coating strategy can hold great application promise for bioengineering blood-contacting devices.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assembly of Metal–Phenolic/Catecholamine Networks for Synergistically Anti-Inflammatory, Antimicrobial, and Anticoagulant Coatings

Gao

Tan

et al. 2018

ACS Appl. Mater. Interfaces

133

View full text Add to dashboard Cite

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Section: Immune-associated Thrombocytopeniamentioning

confidence: 99%

“…Secondary causes of IAT may be medication related, such as with thienopyridines like clopidogrel (refer to the section on TTP), or as a manifestation of heparin-induced thrombocytopenia. 37,38 Heparin-induced thrombocytopenia is a serious condition indicated by a decline in platelet count of more than 50%, often beginning within 5 to 10 days after starting heparin therapy. Heparin-induced thrombocytopenia may lead to catastrophic thromboembolic events and requires immediate cessation of heparinoid products and initiation of a nonheparinoid anticoagulant.…”

Section: Key Pointsmentioning

confidence: 99%

Hematologic Disorders and the Nervous System

Mauermann¹,

Southerland²

2023

CONTINUUM: Lifelong Learning in Neurology

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OBJECTIVE This article discusses the epidemiology, diagnosis, treatment, and prevention of neurologic complications of red blood cell, platelet, and plasma cell disorders. LATEST DEVELOPMENTS Cerebrovascular complications can occur in patients with blood cell and platelet disorders. Treatment strategies to prevent stroke are available for patients with sickle cell disease, polycythemia vera, and essential thrombocythemia. A diagnosis of thrombotic thrombocytopenic purpura should be considered in patients with neurologic symptoms, hemolytic anemia, thrombocytopenia, mild renal insufficiency, and fever. Plasma cell disorders can be associated with peripheral neuropathy, and classification of the monoclonal protein type and neuropathy aid in diagnosis. Patients with POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal plasma cell disorder, and skin changes) syndrome can present with arterial and venous neurologic events. ESSENTIAL POINTS This article discusses the neurologic complications of blood cell disorders and the most recent advances in prevention and treatment.

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“…20,24 There are numerous case reports of heparin-induced thrombocytopenia causing ischemic strokes. 18,23,25,26 ISCHEMIC STROKE: THROMBOTIC THROMBOPENIA PURPURA PATHOPHYSIOLOGY Thrombotic thrombopenia purpura (TTP) is a congenital or acquired disease in which platelets spontaneously form thrombin. 27,28 Thrombotic thrombopenia purpura is often accompanied by microangiopathy (a disease of the capillary walls) and hemolytic anemia.…”

Section: Ischemic Stroke: Heparin-induced Thrombocytopenia Pathophysi...mentioning

confidence: 99%

Call for Manuscripts

2021

Dimens Crit Care Nurs

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Background: There are 2 classification of strokes: ischemic, if caused by an arterial occlusion from a clot or obstruction by atherosclerosis, and hemorrhagic, if caused by the rupture of a vessel and subsequent bleeding. Each type of stroke is influenced by platelet counts and platelet function. The intention of this article is to discuss the role of the platelet in the pathophysiology of acute stroke processes. This serves as a prelude to discussing these processes as disrupted with thrombocytopenia (low platelet counts). Platelets initiate clot formation and obstruct blood flow through the creation of a platelet plug. They also extend the penumbra in ischemic and hemorrhagic strokes. Thrombocytopenia can be a causal factor in an ischemic stroke, a risk factor for hemorrhagic stroke, and a risk factor for hemorrhagic stroke conversion. Methods: The aims of this study were to review 1 case study that illustrates the pivotal role of the platelet in strokes and to review the aspect that was impacted by autoimmune thrombocytopenia. Discussion: Thrombocytopenia is a hematologic disorder not often included in stroke care discussions. Thrombocytopenia sets up strokes to occur and, paradoxically, may also set the patient up for bleeding complications in the brain or groin. Conclusion: Acknowledging the impact of both platelet and thrombocytopenia on stroke causation, stroke interventions, and outcomes is a pivotal aspect of comprehensive stroke care. Platelet function processes are impactful in each point of the continuum of stroke care, prevention, intervention, and discharge.

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A Case of Posterior Circulation Ischemic Stroke Caused by Heparin-Induced Thrombocytopenia after Detaining Hepatic Arterial Infusion Catheter

Cited by 8 publications

References 11 publications

Assembly of Metal–Phenolic/Catecholamine Networks for Synergistically Anti-Inflammatory, Antimicrobial, and Anticoagulant Coatings

Assembly of Metal–Phenolic/Catecholamine Networks for Synergistically Anti-Inflammatory, Antimicrobial, and Anticoagulant Coatings

Hematologic Disorders and the Nervous System

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