Argatroban administration resulted in no procedural complications in 3 patients with heparin sensitivity undergoing neurointerventional procedures.
Case Report (n=3)
Does argatroban provide safe anticoagulation in patients with heparin-induced thrombocytopenia undergoing neurointerventional procedures?
Argatroban may serve as a safe alternative anticoagulant for patients with heparin-induced thrombocytopenia undergoing neurointerventional procedures.
BACKGROUND: Currently, heparin is used routinely for anticoagulation during cerebral angiography and neurointerventional procedures. In patients with heparin sensitivity, however, heparin cannot be used. Therefore, an alternative method of anticoagulation is necessary to prevent clot formation during such procedures. METHODS: Argatroban, a direct thrombin inhibitor, is used as an alternate to heparin for anticoagulation. It is indicated for treatment of heparin induced thrombocytopenia as well as for prophylaxis during percutaneous coronary intervention. There are no reports describing the protocols for its use during neurointerventional procedures. We report on a series of three patients where argatroban was used in a series of three patients who underwent endovascular interventional procedures. RESULTS: Argatroban was given in a loading dosage of 4 μg/kg/min for 10 min followed by an infusion of 1.0 μg/kg/min. During the procedure, no procedural complications were reported. Activated thrombin time was used to monitor anticoagulation. CONCLUSIONS: We describe here the use of argatroban as an alternate anticoagulant during such procedures, as well as outline our protocol for its administration.
Alaraj et al. (2013) conducted a case report in Heparin induced thrombocytopenia (n=3). Argatroban was evaluated on Procedural complications. Argatroban administration resulted in no procedural complications in 3 patients with heparin sensitivity undergoing neurointerventional procedures.