Anticoagulation in a Neurosurgical Patient with Heparin-Induced Thrombocytopenia Type II with Argatroban and Fondaparinux after Clipping of an Intracranial Aneurysm.
BACKGROUND: Therapeutic anticoagulation in patients after a major neurosurgical procedure remains critical because of the risk of a major intracranial bleed. Novel drugs could play a beneficial role in this setting. CASE REPORT: We describe a patient with heparin-induced thrombocytopenia type II and pulmonary embolism who was anticoagulated with argatroban and, later, with fondaparinux. No intracranial bleeding was detected when anticoagulation was performed with argatroban and, later, fondaparinux. CONCLUSION: Both substances could have therapeutic potential in this context.
Kerz
Thomas
T
Department of Neurosurgery, Johannes Gutenberg University Medical School, Mainz, Germany.
Schinzel
Helmut
H
Drugs Today (Barc). 2006 Apr;42(4):223-36
16703119
Ann Pharmacother. 2006 Jul-Aug;40(7-8):1383-7
16788093
Semin Thromb Hemost. 2006 Nov;32(8):803-9
17171593
Stroke. 2004 Jul;35(7):1677-82
15155959
N Engl J Med. 2007 Jun 21;356(25):2653-5; discussion 2653-5
17582083
Pharmacotherapy. 2003 Jun;23(6):745-53
12820817
Curr Hematol Rep. 2003 Mar;2(2):148-57
12901146
Clin Appl Thromb Hemost. 2008 Oct;14(4):410-4
17895512