Key result
A 2-hour course of plasma exchange successfully reversed the anticoagulant effect of apixaban, reducing anti-Xa (UFH) levels from 0.76 to 0.22 IU/mL and facilitating pericardiocentesis.
Case Report (n=1)
Plasmapheresis enabled apixaban reversal in post-pacemaker effusion; hypothesis-generating and should not yet change practice.
We report the case of an 82-year-old man in whom hemorrhagic pericardial effusion occurred one week after pacemaker implantation, while he was taking apixaban. Few therapies exist for reversing the anti-Xa effect of apixaban. To reverse anticoagulation, our patient underwent plasma exchange, which facilitated pericardiocentesis and prevented possible surgical intervention. To our knowledge, this is the first report of the use of plasmapheresis to reverse the anticoagulant effect of apixaban.
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Lam et al. (2015) conducted a case report in Hemorrhagic pericardial effusion and cardiac tamponade (n=1). Plasma exchange was evaluated on Anti-Xa levels. A 2-hour course of plasma exchange successfully reversed the anticoagulant effect of apixaban, reducing anti-Xa (UFH) levels from 0.76 to 0.22 IU/mL and facilitating pericardiocentesis.
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