Direct-Thrombin Inhibitor Utilization in Patients With Heparin-Induced Thrombocytopenia and Undergoing Catheter-Directed Thrombolysis: A Summary of Published Case Reports.
Journal
The Journal of cardiovascular nursing
ISSN: 1550-5049
Titre abrégé: J Cardiovasc Nurs
Pays: United States
ID NLM: 8703516
Informations de publication
Date de publication:
Historique:
pubmed:
14
12
2018
medline:
4
9
2020
entrez:
14
12
2018
Statut:
ppublish
Résumé
Catheter-directed thrombolysis (CDT) is one of the emerging venous thromboembolism management modalities. There are fairly limited data regarding the use of direct-thrombin inhibitors (DTIs) in patients with heparin-induced thrombocytopenia and undergoing CDT. The aim of this study was to provide a summary of the available evidence supporting the use of DTIs in patients undergoing CDT. We included 6 case reports in our analysis after searching for peer-reviewed articles and case reports in multiple research engines. Four of the 6 cases used argatroban, and 2 cases used bivalirudin. Alteplase was used in all of the 6 cases. All cases used lower activated partial thromboplastin time target. The average initial dose of alteplase ranged from 0.5 to 3 mg/h. The average duration of CDT was 26 hours (SD, 13 hours). Five patients (83%) survived after the procedure, and no complications were reported. The use of DTIs might be safe and effective in selected patients with heparin-induced thrombocytopenia and undergoing CDT.
Sections du résumé
BACKGROUND
Catheter-directed thrombolysis (CDT) is one of the emerging venous thromboembolism management modalities. There are fairly limited data regarding the use of direct-thrombin inhibitors (DTIs) in patients with heparin-induced thrombocytopenia and undergoing CDT.
OBJECTIVES
The aim of this study was to provide a summary of the available evidence supporting the use of DTIs in patients undergoing CDT.
METHODS AND RESULTS
We included 6 case reports in our analysis after searching for peer-reviewed articles and case reports in multiple research engines. Four of the 6 cases used argatroban, and 2 cases used bivalirudin. Alteplase was used in all of the 6 cases. All cases used lower activated partial thromboplastin time target. The average initial dose of alteplase ranged from 0.5 to 3 mg/h. The average duration of CDT was 26 hours (SD, 13 hours). Five patients (83%) survived after the procedure, and no complications were reported.
CONCLUSIONS
The use of DTIs might be safe and effective in selected patients with heparin-induced thrombocytopenia and undergoing CDT.
Identifiants
pubmed: 30543545
doi: 10.1097/JCN.0000000000000555
doi:
Substances chimiques
Anticoagulants
0
Antithrombins
0
Heparin
9005-49-6
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM