We report a case of an acute stroke patient with pulmonary embolism (PE) caused by delayed-onset heparin-induced thrombocytopenia (HIT). She was treated with heparin to prevent neurological deterioration. However, 5 days after heparin had been given for 7 days, she developed PE. Heparin was re-started, but the platelet count decreased significantly, and a right ventricular thrombus appeared. Sh...

Heparin-induced thrombocytopenia (HIT) is a serious complication of heparin therapy that has a high rate of morbidity (thrombosis and amputation) and mortality. In the past, a number of different anticoagulants have been used to treat HIT in an attempt to prevent these complications. More recently, direct thrombin inhibitors have become popular. This systematic review summarizes the risk for th...

In an era where medical and critical care patients are more commonly subject to thromboprophylaxis, prompt recognition and appropriate treatment of Heparin-induced thrombocytopaenia (HIT) is required to reduce the risk of serious thrombotic events. In this issue of the Clinical Kidney Journal, Thong et al. present two cases of HIT after initiation of dialysis therapy with heparin as anticoagula...

Tremendous improvements have been made in the outcomes of patients with acute venous thromboembolic events (VTE) since Murray et al. successfully administered heparin to postsurgery patients in 1937 [1]. Advances include accurate methods for diagnosis of deep vein thromboses (DVT) and pulmonary emboli (PE); effective regimens for initial and long-term anticoagulation; and wide acceptance of a s...

We report a patient who developed drug-eluting stent (DES) thrombosis induced by discontinuation of dual antiplatelet therapy (DAPT) and subsequently had a massive surgical site bleed caused by restarting heparin and DAPT during the perioperative period. An 85-year-old man visited a local hospital owing to complaints dyspnea. He was diagnosed with laryngeal cancer and was scheduled for a total ...

STUDY OBJECTIVE To determine physicians' anticoagulation preferences in patients with a mechanical heart valve who are undergoing elective surgery, and to determine the effect of different risks of thromboembolism (TE) and postoperative bleeding on anticoagulation preferences. DESIGN Mail survey of physicians who prescribe anticoagulant therapy. METHODS AND RESULTS Physicians were asked to ...

AIM To identify risk factors for post-polypectomy bleeding (PPB), focusing on antithrombotic agents. METHODS This was a case-control study based on medical records at a single center. PPB was defined as bleeding that occurred 6 h to 10 d after colonoscopic polypectomy and required endoscopic hemostasis. As risk factors for PPB, patient-related factors including anticoagulants, antiplatelets a...

background: this study was designed to examine a unique and low dose use of intravenous enoxaparin in elective percutaneous coronary intervention (pci) that would be applicable to an unselected population regardless of age, weight, and renal function. there is limited experience in anticoagulation using intravenous low-molecular-weight heparin in pci. methods: a total of 100 consecutive patient...

Many guidelines for the management of antithrombotic therapy in endoscopic procedures state that warfarin should be replaced by heparin in high risk endoscopic procedures. However, heparin bridging therapy is costly, requires a long hospital stay, and is indicated as a risk factor for bleeding after endoscopic submucosal dissection (ESD). It is not yet clear whether it is better to perform gast...

Thrombocytopenia is a well- recognized complication of heparin therapy. The diagnosis is mostly clinical and the main value of laboratory testing is in excluding the diagnosis. We describe here a patient with stroke who had aspiration pneumonia leading to sepsis. She developed atrial fibrillation and received heparin which had to be stopped prematurely due to melena. Within 5 days of heparin, s...