Local Intraluminal Irrigation With Argatroban During Free Flap Repair in a Patient With Heparin-Induced Thrombocytopenia

Ann Otol Rhinol Laryngol. 2017 May;126(5):407-410. doi: 10.1177/0003489417693015. Epub 2017 Mar 1.

Abstract

Objective: This study describes a case of a successful free flap repair using argatroban for local intraluminal irrigation as a substitute to heparin in a patient with heparin-induced thrombocytopenia.

Methods: Case report and review of literature.

Results: The patient had an uneventful postoperative course, and the free flap survived without complications.

Conclusions: The use of argatroban during microvascular surgery is likely to be safe and simple and may be effective in preventing micro-thrombotic complications during microvascular surgery, and it should be considered as an alternative to heparinized saline for local intraluminal irrigation.

Keywords: argatroban; free flap reconstruction; head and neck cancer; head and neck reconstruction; head and neck surgery; heparin-induced thrombocytopenia; microsurgery; radial forearm free flap.

Publication types

  • Case Reports

MeSH terms

  • Arginine / analogs & derivatives
  • Carcinoma, Squamous Cell* / pathology
  • Carcinoma, Squamous Cell* / surgery
  • Female
  • Forearm / surgery
  • Free Tissue Flaps / blood supply
  • Head and Neck Neoplasms* / pathology
  • Head and Neck Neoplasms* / surgery
  • Humans
  • Middle Aged
  • Mouth Neoplasms* / pathology
  • Mouth Neoplasms* / surgery
  • Neck Dissection / methods*
  • Pipecolic Acids / administration & dosage*
  • Platelet Aggregation Inhibitors / administration & dosage
  • Radial Artery / surgery
  • Sulfonamides
  • Treatment Outcome

Substances

  • Pipecolic Acids
  • Platelet Aggregation Inhibitors
  • Sulfonamides
  • Arginine
  • argatroban