title: [Treatment of massive arterial thrombosis caused by thrombocytopenia induced by heparin with local thrombolysis].
abstract: The authors report the case of a patient treated by subcutaneous injection of calcium heparin after deep vein thrombosis with floating thrombus and pulmonary embolism. She was readmitted to hospital after 16 days' treatment because of a massive aorto-iliac thrombosis due to heparin-induced thrombocytopenia (platelet count = 29.000). This thrombosis was treated by local injection of Urokinase (total dose = 7.425.000 U) over 93 hours without any major complications. The aorto-iliac circulation was completely restored to normal after treatment. Thrombotic complications secondary to immuno-allergic heparin-induced thrombocytopenia are relatively common because of the widespread use of heparin. From the therapeutic point of view, it is imperative to stop the heparin, which makes surgery very difficult, and the platelet-fibrin composition of these thrombi suggests that local thrombolysis with Urokinase is the treatment of choice in this syndrome.
authors.affiliation: Département de cardiologie, centre hospitalier de Luxembourg.
authors.forename: C
authors.initials: C
authors.lastname: Delagardelle
authors.forename: C
authors.initials: C
authors.lastname: Harf
authors.forename: R F
authors.initials: RF
authors.lastname: Dondelinger
authors.forename: P
authors.initials: P
authors.lastname: Goffette
authors.forename: J
authors.initials: J
authors.lastname: Beissel
authors.forename: C
authors.initials: C
authors.lastname: Pesch
authors.forename: R
authors.initials: R
authors.lastname: Welter
mesh_terms: D001012:Aorta, Abdominal; D001018:Aortic Diseases / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D005263:Femoral Artery; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D007261:Infusions, Intra-Arterial; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000150:complications* / Q000188:drug therapy; D013921:Thrombocytopenia / Q000139:chemically induced / Q000150:complications*; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000379:methods*; D013927:Thrombosis / Q000188:drug therapy / Q000209:etiology*; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D006493:Heparin; D014568:Urokinase-Type Plasminogen Activator
vernacular_title: Traitement par thrombolyse locale d'une thrombose artérielle massive par thrombopénie induite par l'héparine.