Catheter-directed thrombolysis of acute lower extremity arterial thrombosis in a patient with heparin-induced thrombocytopenia.
Heparin-induced thrombocytopenia (HIT) is an underdiagnosed problem, and the optimal treatment of arterial thrombosis in patients with HIT remains controversial. There are many angiographic procedures which require heparin as an adjunctive agent; however, some of the heparin-related complications and their management remains unclear. We are presenting a 77-year-old male patient with HIT, who developed acute lower extremity limb threatening ischemia due to arterial thrombosis. In our case, the patient has been successfully treated with percutaneous catheter-directed thrombolysis with tissue plasminogen activator and a direct thrombin inhibitor argatroban.
Department of Radiology, University of Virginia Health System, Charlottesville, Virginia 22908, USA. uct5d@virginia.edu
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D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D001120:Arginine / Q000031:analogs & derivatives; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D002406:Catheterization, Peripheral; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D007261:Infusions, Intra-Arterial; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D010875:Pipecolic Acids / Q000008:administration & dosage; D011859:Radiography; D013449:Sulfonamides; D013921:Thrombocytopenia / Q000139:chemically induced / Q000150:complications*; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage; D016896:Treatment Outcome
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D010875:Pipecolic Acids; D013449:Sulfonamides; D006493:Heparin; D001120:Arginine; D010959:Tissue Plasminogen Activator; C031942:argatroban