Usefulness of Antiplatelet Drugs in the Management of Heparin-Associated Thrombocytopenia and Thrombosis
Heparin-associated thrombocytopenia and thrombosis is a severe complication of systemic heparin therapy. Its treatment is mainly based upon discontinuation of heparin therapy. However in some patients requiring emergency cardiac or vascular surgery, reexposure to heparin may be unavoidable. We repor...
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| Veröffentlicht in: | Annals of vascular surgery 1991-11, Vol.5 (6), p.552-555 |
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| container_issue | 6 |
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| container_title | Annals of vascular surgery |
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| creator | Gruel, Yves Lermusiaux, Patrick Lang, Marc Darnige, Luc Rupin, Alain Delahousse, Bénédicte Guilmot, Jean-Louis Leroy, Jean |
| description | Heparin-associated thrombocytopenia and thrombosis is a severe complication of systemic heparin therapy. Its treatment is mainly based upon discontinuation of heparin therapy. However in some patients requiring emergency cardiac or vascular surgery, reexposure to heparin may be unavoidable. We report the management of two such patients by use of antiplatelet drugs for a vascular procedure. In the two cases, a combination of lloprost, a stable prostacyclin analogue (1 to 2 ng/kg/mn) with aspirin and dipyridamole was shown to inhibit ex vivo the heparin-induced platelet aggregation. These antiplatelet agents were continued during the perioperative period. A successful vascular procedure was achieved with full heparinization without subsequent thrombocytopenia or thrombotic or hemorrhagic complications. This experience supports the hypothesis that heparin can be readministered early to patients with heparin-associated thrombocytopenia and thrombosis, provided antiplatelet therapy is given. |
| doi_str_mv | 10.1007/BF02015283 |
| format | Article |
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Its treatment is mainly based upon discontinuation of heparin therapy. However in some patients requiring emergency cardiac or vascular surgery, reexposure to heparin may be unavoidable. We report the management of two such patients by use of antiplatelet drugs for a vascular procedure. In the two cases, a combination of lloprost, a stable prostacyclin analogue (1 to 2 ng/kg/mn) with aspirin and dipyridamole was shown to inhibit ex vivo the heparin-induced platelet aggregation. These antiplatelet agents were continued during the perioperative period. A successful vascular procedure was achieved with full heparinization without subsequent thrombocytopenia or thrombotic or hemorrhagic complications. This experience supports the hypothesis that heparin can be readministered early to patients with heparin-associated thrombocytopenia and thrombosis, provided antiplatelet therapy is given.</description><identifier>ISSN: 0890-5096</identifier><identifier>EISSN: 1615-5947</identifier><identifier>DOI: 10.1007/BF02015283</identifier><identifier>PMID: 1722991</identifier><language>eng</language><publisher>Netherlands: Elsevier Inc</publisher><subject>Aged ; antiplatelet drugs ; Aorta, Abdominal ; Aspirin - therapeutic use ; Dipyridamole - therapeutic use ; Female ; Femoral Vein ; Heparin ; Heparin - adverse effects ; heparin-associated thrombocytopenia ; Humans ; Iliac Artery ; Iliac Vein ; Iloprost - therapeutic use ; Ischemia - drug therapy ; lloprost ; Platelet Aggregation - drug effects ; Platelet Aggregation Inhibitors - therapeutic use ; thrombocytopenia ; Thrombocytopenia - chemically induced ; Thrombocytopenia - drug therapy ; thrombosis ; Thrombosis - chemically induced ; Thrombosis - drug therapy ; Vena Cava, Inferior</subject><ispartof>Annals of vascular surgery, 1991-11, Vol.5 (6), p.552-555</ispartof><rights>1991 Annals of Vascular Surgery, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c308t-9e488188b47423d1994a556238e96107287486c7ab4dbd39aa56bced145cf5033</citedby><cites>FETCH-LOGICAL-c308t-9e488188b47423d1994a556238e96107287486c7ab4dbd39aa56bced145cf5033</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0890509606615549$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/1722991$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gruel, Yves</creatorcontrib><creatorcontrib>Lermusiaux, Patrick</creatorcontrib><creatorcontrib>Lang, Marc</creatorcontrib><creatorcontrib>Darnige, Luc</creatorcontrib><creatorcontrib>Rupin, Alain</creatorcontrib><creatorcontrib>Delahousse, Bénédicte</creatorcontrib><creatorcontrib>Guilmot, Jean-Louis</creatorcontrib><creatorcontrib>Leroy, Jean</creatorcontrib><title>Usefulness of Antiplatelet Drugs in the Management of Heparin-Associated Thrombocytopenia and Thrombosis</title><title>Annals of vascular surgery</title><addtitle>Ann Vasc Surg</addtitle><description>Heparin-associated thrombocytopenia and thrombosis is a severe complication of systemic heparin therapy. Its treatment is mainly based upon discontinuation of heparin therapy. However in some patients requiring emergency cardiac or vascular surgery, reexposure to heparin may be unavoidable. We report the management of two such patients by use of antiplatelet drugs for a vascular procedure. In the two cases, a combination of lloprost, a stable prostacyclin analogue (1 to 2 ng/kg/mn) with aspirin and dipyridamole was shown to inhibit ex vivo the heparin-induced platelet aggregation. These antiplatelet agents were continued during the perioperative period. A successful vascular procedure was achieved with full heparinization without subsequent thrombocytopenia or thrombotic or hemorrhagic complications. This experience supports the hypothesis that heparin can be readministered early to patients with heparin-associated thrombocytopenia and thrombosis, provided antiplatelet therapy is given.</description><subject>Aged</subject><subject>antiplatelet drugs</subject><subject>Aorta, Abdominal</subject><subject>Aspirin - therapeutic use</subject><subject>Dipyridamole - therapeutic use</subject><subject>Female</subject><subject>Femoral Vein</subject><subject>Heparin</subject><subject>Heparin - adverse effects</subject><subject>heparin-associated thrombocytopenia</subject><subject>Humans</subject><subject>Iliac Artery</subject><subject>Iliac Vein</subject><subject>Iloprost - therapeutic use</subject><subject>Ischemia - drug therapy</subject><subject>lloprost</subject><subject>Platelet Aggregation - drug effects</subject><subject>Platelet Aggregation Inhibitors - therapeutic use</subject><subject>thrombocytopenia</subject><subject>Thrombocytopenia - chemically induced</subject><subject>Thrombocytopenia - drug therapy</subject><subject>thrombosis</subject><subject>Thrombosis - chemically induced</subject><subject>Thrombosis - drug therapy</subject><subject>Vena Cava, Inferior</subject><issn>0890-5096</issn><issn>1615-5947</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1991</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkMFLwzAUh4Moc04v3oWchWqSJm1ynNOpMPGynUuavm6RNi1JJuy_t6PiLp4evN_H7z0-hG4peaCE5I9PS8IIFUymZ2hKMyoSoXh-jqZEKpIIorJLdBXCFyGUSS4naEJzxpSiU7TbBKj3jYMQcFfjuYu2b3SEBiJ-9vttwNbhuAP8oZ3eQgsuHrk36LW3LpmH0Bk78BVe73zXlp05xK4HZzXW7m8ZbLhGF7VuAtz8zhnaLF_Wi7dk9fn6vpivEpMSGRMFXEoqZclzztKKKsW1EBlLJaiMkpzJnMvM5LrkVVmlSmuRlQYqyoWpBUnTGbofe43vQvBQF723rfaHgpLiaKs42RrguxHu92UL1Qkd9Qw5H3MYPv624ItgLLjhnvVgYlF19r_aH3ssdhg</recordid><startdate>199111</startdate><enddate>199111</enddate><creator>Gruel, Yves</creator><creator>Lermusiaux, Patrick</creator><creator>Lang, Marc</creator><creator>Darnige, Luc</creator><creator>Rupin, Alain</creator><creator>Delahousse, Bénédicte</creator><creator>Guilmot, Jean-Louis</creator><creator>Leroy, Jean</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>199111</creationdate><title>Usefulness of Antiplatelet Drugs in the Management of Heparin-Associated Thrombocytopenia and Thrombosis</title><author>Gruel, Yves ; Lermusiaux, Patrick ; Lang, Marc ; Darnige, Luc ; Rupin, Alain ; Delahousse, Bénédicte ; Guilmot, Jean-Louis ; Leroy, Jean</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c308t-9e488188b47423d1994a556238e96107287486c7ab4dbd39aa56bced145cf5033</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1991</creationdate><topic>Aged</topic><topic>antiplatelet drugs</topic><topic>Aorta, Abdominal</topic><topic>Aspirin - therapeutic use</topic><topic>Dipyridamole - therapeutic use</topic><topic>Female</topic><topic>Femoral Vein</topic><topic>Heparin</topic><topic>Heparin - adverse effects</topic><topic>heparin-associated thrombocytopenia</topic><topic>Humans</topic><topic>Iliac Artery</topic><topic>Iliac Vein</topic><topic>Iloprost - therapeutic use</topic><topic>Ischemia - drug therapy</topic><topic>lloprost</topic><topic>Platelet Aggregation - drug effects</topic><topic>Platelet Aggregation Inhibitors - therapeutic use</topic><topic>thrombocytopenia</topic><topic>Thrombocytopenia - chemically induced</topic><topic>Thrombocytopenia - drug therapy</topic><topic>thrombosis</topic><topic>Thrombosis - chemically induced</topic><topic>Thrombosis - drug therapy</topic><topic>Vena Cava, Inferior</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gruel, Yves</creatorcontrib><creatorcontrib>Lermusiaux, Patrick</creatorcontrib><creatorcontrib>Lang, Marc</creatorcontrib><creatorcontrib>Darnige, Luc</creatorcontrib><creatorcontrib>Rupin, Alain</creatorcontrib><creatorcontrib>Delahousse, Bénédicte</creatorcontrib><creatorcontrib>Guilmot, Jean-Louis</creatorcontrib><creatorcontrib>Leroy, Jean</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Annals of vascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gruel, Yves</au><au>Lermusiaux, Patrick</au><au>Lang, Marc</au><au>Darnige, Luc</au><au>Rupin, Alain</au><au>Delahousse, Bénédicte</au><au>Guilmot, Jean-Louis</au><au>Leroy, Jean</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Usefulness of Antiplatelet Drugs in the Management of Heparin-Associated Thrombocytopenia and Thrombosis</atitle><jtitle>Annals of vascular surgery</jtitle><addtitle>Ann Vasc Surg</addtitle><date>1991-11</date><risdate>1991</risdate><volume>5</volume><issue>6</issue><spage>552</spage><epage>555</epage><pages>552-555</pages><issn>0890-5096</issn><eissn>1615-5947</eissn><abstract>Heparin-associated thrombocytopenia and thrombosis is a severe complication of systemic heparin therapy. Its treatment is mainly based upon discontinuation of heparin therapy. However in some patients requiring emergency cardiac or vascular surgery, reexposure to heparin may be unavoidable. We report the management of two such patients by use of antiplatelet drugs for a vascular procedure. In the two cases, a combination of lloprost, a stable prostacyclin analogue (1 to 2 ng/kg/mn) with aspirin and dipyridamole was shown to inhibit ex vivo the heparin-induced platelet aggregation. These antiplatelet agents were continued during the perioperative period. A successful vascular procedure was achieved with full heparinization without subsequent thrombocytopenia or thrombotic or hemorrhagic complications. This experience supports the hypothesis that heparin can be readministered early to patients with heparin-associated thrombocytopenia and thrombosis, provided antiplatelet therapy is given.</abstract><cop>Netherlands</cop><pub>Elsevier Inc</pub><pmid>1722991</pmid><doi>10.1007/BF02015283</doi><tpages>4</tpages></addata></record> |
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| ispartof | Annals of vascular surgery, 1991-11, Vol.5 (6), p.552-555 |
| issn | 0890-5096 1615-5947 |
| language | eng |
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| subjects | Aged antiplatelet drugs Aorta, Abdominal Aspirin - therapeutic use Dipyridamole - therapeutic use Female Femoral Vein Heparin Heparin - adverse effects heparin-associated thrombocytopenia Humans Iliac Artery Iliac Vein Iloprost - therapeutic use Ischemia - drug therapy lloprost Platelet Aggregation - drug effects Platelet Aggregation Inhibitors - therapeutic use thrombocytopenia Thrombocytopenia - chemically induced Thrombocytopenia - drug therapy thrombosis Thrombosis - chemically induced Thrombosis - drug therapy Vena Cava, Inferior |
| title | Usefulness of Antiplatelet Drugs in the Management of Heparin-Associated Thrombocytopenia and Thrombosis |
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