Use of systemic bivalirudin with catheter-directed thrombolysis in a patient with heparin-induced thrombocytopenia: A case report

Catheter Cardiovasc Interv. 2018 Feb 15;91(3):E17-E20. doi: 10.1002/ccd.27368. Epub 2017 Oct 25.

Abstract

In patients with submassive pulmonary embolism, the use of catheter-directed thrombolysis (CDT), using low-dose alteplase is associated with improvement in overall hemodynamics. The data for use of CDT in patients with heparin-induced thrombocytopenia are limited. We report a case of CDT in a patient with HIT using bivalirudin anticoagulation. Data of the use of bivalirudin and argatroban for systemic anticoagulation with CDT are limited.

Keywords: bivalirudin; catheter-directed thrombolysis; heparin-induced thrombocytopenia.

Publication types

  • Case Reports

MeSH terms

  • Anticoagulants / administration & dosage
  • Anticoagulants / adverse effects*
  • Antithrombins / administration & dosage*
  • Blood Coagulation / drug effects
  • Drug Administration Schedule
  • Drug Substitution
  • Fatal Outcome
  • Fibrinolytic Agents / administration & dosage*
  • Heparin / administration & dosage
  • Heparin / adverse effects*
  • Hirudins / administration & dosage*
  • Humans
  • Infusions, Intravenous
  • Male
  • Middle Aged
  • Peptide Fragments / administration & dosage*
  • Pulmonary Embolism / blood
  • Pulmonary Embolism / diagnosis
  • Pulmonary Embolism / drug therapy*
  • Recombinant Proteins / administration & dosage
  • Thrombocytopenia / blood
  • Thrombocytopenia / chemically induced*
  • Thrombocytopenia / diagnosis
  • Thrombolytic Therapy*
  • Tissue Plasminogen Activator / administration & dosage*
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Anticoagulants
  • Antithrombins
  • Fibrinolytic Agents
  • Hirudins
  • Peptide Fragments
  • Recombinant Proteins
  • Heparin
  • Tissue Plasminogen Activator
  • bivalirudin