Recent Myocardial Infarction and Acute Heparin-Induced Thrombocytopenia: A Case Report on Perioperative Management of a Patient for Acute Limb Vascular Surgery

Case Reports

. 2022 Oct 27;14(10):e30763.

doi: 10.7759/cureus.30763.

eCollection 2022 Oct.

Affiliations

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Case Reports

Sara Nogueira et al.

Cureus.

2022.

Abstract

The optimal alternative anticoagulation regimen for patients with heparin-induced thrombocytopenia (HIT) who need surgical procedures that involve higher levels of anticoagulation, usually performed under heparin, is not yet established. Argatroban has been reported as a safe alternative. Plasma levels and their anticoagulant effects follow a predictable profile. Also, it is easily monitored and its pharmacokinetic profile makes it suitable for patients with renal failure, as it undergoes hepatic elimination. However, its use as a substitute for heparin in HIT patients is not well-documented, especially in vascular surgery. We present a case of a successfully managed patient with acute HIT undergoing limb vascular surgery using anticoagulation with argatroban.

Keywords:

acute limb ischaemia; acute myocardial infarction; argatroban; heparin induced thrombocytopenia; perioperative period; vascular surgery.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1. Digital subtraction angiography showing occlusion of the right superficial femoral artery

**Figure 2. Digital subtraction angiography showing limb revascularization**

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