Rivaroxaban for arterial thrombosis related to heparin-induced thrombocytopenia
(2015) Blood Coagulation and Fibrinolysis — Vol. 26, n° 2, p. 205-206 (2015)
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- Abstract
- Heparin-induced thrombocytopenia (HIT) may be a critical condition in intensive care patients. Diagnosis of HIT is often difficult, and management too, as physicians have usually a limited experience with alternative anticoagulants. A 36-year-old man was admitted for orthopaedic surgery after a trauma causing a fracture of the sacrum and right ankle. Anticoagulant prophylaxis was made by nadroparin (3800IU/day). But the patient developed less than 10 days after nadroparin exposure a significant drop in platelet count. The diagnosis of HIT was based on the pretest clinical score and demonstration of platelet factor 4 and heparin antibodies. Fondaparinux was transiently administered but was replaced 3 days later by rivaroxaban (15mg twice a day during 21 days then 20mg/day), after the demonstration of an acute thrombosis of the left radial artery. Platelet count returned to normal range and a partial recanalization of arterial thrombosis was noted. The use of rivaroxaban in this indication is of theoretical interest but requires further experience.
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Hantson, P., Lambert, C., & Hermans, C. (2015). Rivaroxaban for arterial thrombosis related to heparin-induced thrombocytopenia. Blood Coagulation and Fibrinolysis, 26(2), 205-206. https://doi.org/10.1097/MBC.0000000000000205 (Original work published 2015)