RT Journal Article
SR Electronic
T1 Heparin induced thrombocytopenia: diagnosis and management
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 371
OP 378
DO 10.1136/jnis.2010.002840
VO 2
IS 4
A1 Ali Alaraj
A1 Adam Wallace
A1 Eljim Tesoro
A1 Sean Ruland
A1 Sepideh Amin-Hanjani
A1 Fady T Charbel
A1 Victor Aletich
YR 2010
UL http://jnis.bmj.com/content/2/4/371.abstract
AB The incidence of heparin induced thrombocytopenia (HIT) in neurological patients continues to increase with expansion of indication for neurointerventional procedures. The pathophysiology of HIT is related to a hypersensitivity reaction against complex platelet factor 4. The diagnosis is mostly clinical and is often confirmed by laboratory testing. Patients with HIT have a higher rate of thromboembolic complications, both arterial and venous, and with worse neurological outcomes at the time of discharge. Early diagnosis and heparin cessation are essential in the management of those patients. Both immediate and prolonged alternative anticoagulation are necessary. Understanding of the mechanism of action, indication and drug interaction of the alternative anticoagulants (direct thrombin inhibitors, fondaparinux and danaparoid) and warfarin is essential during management of these patients.