Use of Argatroban as a Procedural and Bridging Anticoagulant in a Patient Undergoing Carotid Endarterectomy with Concomitant Atrial Fibrillation

Nanda, Manisha M; Kauflin, Matthew J; Jain, Priya G; Yannetta, Jacob C

doi:10.1345/aph.1p709

Cited by 7 publications

(3 citation statements)

References 4 publications

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“…Non-valvüler atriyal fibrilasyonu olan ve bu sebeple warfarin tedavisi alan hastalarda karotis endarterektomi operasyonu öncesi INR değeri düşene kadar medikasyona fraksiyone heparin ile birlikte devam edilmektedir. Literatürde heparin kaynaklı trombositopeni saptanan ve atriyal fibrilasyonu olan hastalarda warfarin kesildikten sonra argatroban infüzyonunun kullanıldığını bildiren çalışmalar mevcuttur (18).…”

Section: Discussionunclassified

Atri̇al Fi̇bri̇lasyon Nedeni̇yle Karoti̇s Endarterektomi̇si̇ Geçi̇ren Hastalarda Postoperati̇f Anti̇koagülan Ve Anti̇agregan Strateji̇si̇ - Tek Merkez Tecrübesi̇

Öztaş¹,

Uğurlucan²,

Akay³

et al. 2019

J Istanb Fac Med

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Section: Discussionunclassified

Atri̇al Fi̇bri̇lasyon Nedeni̇yle Karoti̇s Endarterektomi̇si̇ Geçi̇ren Hastalarda Postoperati̇f Anti̇koagülan Ve Anti̇agregan Strateji̇si̇ - Tek Merkez Tecrübesi̇

Öztaş¹,

Uğurlucan²,

Akay³

et al. 2019

J Istanb Fac Med

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show abstract

“…Stribling and associates propose to treat the presence HPF4 antibodies in high-risk clinical scenarios with nonheparin anticoagulants or direct thrombin inhibitors [ 13 ]. However, limited evidence is available to guide on the optimal nonheparin anticoagulant to be used during vascular surgery with suspected or documented HIT [ 29 , 30 ]. The ELISA immunoassay is a quantitative test capable of detecting HPF4 antibodies [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Elevated Heparin-Induced Antibodies Are More Common in Diabetic Patients with Vascular Disease

et al. 2014

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Background. Hypercoagulable disorders can lead to deep vein thrombosis (DVT), arterial thrombosis or embolization, and early or recurrent bypass graft failure. The purpose of this study was to identify whether diabetes increased the likelihood of heparin-induced platelet factor 4 antibodies in at risk vascular patients. Methods. We reviewed clinical data on 300 consecutive patients. A hypercoagulable workup was performed if patients presented with (1) early bypass/graft thrombosis (<30 days), (2) multiple bypass/graft thrombosis, and (3) a history of DVT, pulmonary embolus (PE), or native vessel thrombosis. Relevant clinical variables were analyzed and compared between patients with diabetes (DM) and without diabetes (nDM). Results. 85 patients (47 women; age 53 ± 16 years, range 16–82 years) had one of the defined conditions and underwent a hypercoagulable evaluation. Screening was done in 4.7% of patients with early bypass graft thrombosis, 60% of patients were screened because of multiple bypass or graft thrombosis, and 35.3% had a previous history of DVT, PE, or native vessel thrombosis. Of the 43 patients with DM and 42 nDM evaluated, 59 patients (69%) had an abnormal hypercoagulable profile. An elevated heparin antibody level was present in 30% of DM and 12% of nDM patients (chi-squared test P < 0.04). Additionally, DM was associated with a higher likelihood of arterial complications while nDM was associated with a higher rate of venous adverse events (chi-squared test P < 0.003). Conclusions. Diabetes is associated with a higher likelihood of developing heparin-induced antibodies and an increased combined incidence of arterial complications that include early or multiple bypass/graft thrombosis. This finding may influence the choice of anticoagulation in diabetic patients at risk with vascular disease.

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“…Stribling and associates propose to treat the presence HPF4 antibodies in high-risk clinical scenarios with nonheparin anticoagulants or direct thrombin inhibitors [13]. However, limited evidence is available to guide on the optimal nonheparin anticoagulant to be used during vascular surgery with suspected or documented HIT [29,30]. The ELISA immunoassay is a quantitative test capable of detecting HPF4 antibodies [31].…”

Section: Discussionmentioning

confidence: 99%

Elevated Heparin Induced Antibodies are More Common in Diabetic Patients With Vascular Disease

Patel

Street

Haydar

et al. 2013

Journal of Surgical Research

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Use of Argatroban as a Procedural and Bridging Anticoagulant in a Patient Undergoing Carotid Endarterectomy with Concomitant Atrial Fibrillation

Abstract: Argatroban may be an effective anticoagulant during carotid endarterectomy in patients with underlying chronic renal disease and a history of HIT. Additional research is needed to determine the ideal anticoagulant in vascular surgery when heparin cannot be utilized.

Cited by 7 publications

References 4 publications

Atri̇al Fi̇bri̇lasyon Nedeni̇yle Karoti̇s Endarterektomi̇si̇ Geçi̇ren Hastalarda Postoperati̇f Anti̇koagülan Ve Anti̇agregan Strateji̇si̇ - Tek Merkez Tecrübesi̇

Atri̇al Fi̇bri̇lasyon Nedeni̇yle Karoti̇s Endarterektomi̇si̇ Geçi̇ren Hastalarda Postoperati̇f Anti̇koagülan Ve Anti̇agregan Strateji̇si̇ - Tek Merkez Tecrübesi̇

Elevated Heparin-Induced Antibodies Are More Common in Diabetic Patients with Vascular Disease

Elevated Heparin Induced Antibodies are More Common in Diabetic Patients With Vascular Disease

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