Heparin-induced thrombocytopenia in the presence of a heparin-bonded bypass graft.
The use of prosthetic grafts in below-knee bypasses may be necessary in patients with no available autologous vein and critical limb ischemia not amenable to angioplasty. Such conduits, however, have generally yielded disappointing results. A new, heparin-bonded, expanded polytetrafluoroethylene graft (Gore Propaten vascular graft) designed to provide resistance to thrombosis may be associated with decreased early graft failure and increased patency. A concern with exposure to heparin, and therefore heparin-bonded prostheses, is the development of heparin-induced thrombocytopenia (HIT). Although rare, this requires prompt graft removal. We present a case to highlight this serious complication and review the literature on this topic.
Division of Vascular Surgery, Toronto General Hospital, Toronto, ON, Canada.
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Wheatcroft
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Greco
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Tse
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Roche-Nagle
D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects*; D001807:Blood Vessel Prosthesis; D005260:Female; D006083:Graft Occlusion, Vascular / Q000188:drug therapy*; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D058729:Peripheral Arterial Disease / Q000601:surgery*; D011138:Polytetrafluoroethylene; D013921:Thrombocytopenia / Q000139:chemically induced*
D000925:Anticoagulants; D011138:Polytetrafluoroethylene; D006493:Heparin