Abstract | BACKGROUND: METHODS: RESULTS: The endarterectomy was successfully performed while the patient received argatroban, both as a continuous infusion and intermittent irrigation during dissection of the plaque. Postoperatively, the drip was continued for 24 hours, and the patient was discharged day 2 on a daily dose of 325 mg of aspirin. At the 6-month examination, Doppler ultrasound revealed normal anterograde velocities with no evidence of stenosis, and the patient noted no subsequent ischemic events. CONCLUSIONS: We now recommend systemic intravenous and local argatroban irrigation to prevent thromboembolic complications in CEA cases with HIT and renal insufficiency. Bivalirudin for both systemic intravenous use and local irrigation may be safer in patients without renal insufficiency because of its shorter half-life.
|
Authors | Joseph C Serrone, Norberto Andaluz, Victoria Brink, Mario Zuccarello, Susan L Ware |
Journal | World neurosurgery
(World Neurosurg)
2013 Jul-Aug
Vol. 80
Issue 1-2
Pg. 222.e15-8
ISSN: 1878-8769 [Electronic] United States |
PMID | 23321376
(Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
|
Copyright | Copyright © 2013 Elsevier Inc. All rights reserved. |
Chemical References |
- Anticoagulants
- Pipecolic Acids
- Sulfonamides
- Heparin
- Arginine
- argatroban
|
Topics |
- Aged
- Anticoagulants
(administration & dosage, adverse effects, therapeutic use)
- Arginine
(analogs & derivatives)
- Carotid Stenosis
(pathology, surgery)
- Cerebral Angiography
- Endarterectomy, Carotid
(methods)
- Heparin
(adverse effects, immunology)
- Humans
- Infarction, Middle Cerebral Artery
(complications)
- Infusions, Intravenous
- Magnetic Resonance Imaging
- Male
- Pipecolic Acids
(administration & dosage, therapeutic use)
- Postoperative Period
- Sulfonamides
- Therapeutic Irrigation
- Thrombocytopenia
(chemically induced, drug therapy)
- Treatment Outcome
|