PMID- 30546621
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200929
IS  - 1878-5409 (Electronic)
IS  - 1878-5409 (Linking)
VI  - 13
IP  - 4
DP  - 2016 Apr
TI  - Pulse-spray catheter-directed thrombolysis with urokinase and argatroban for 
      thrombo-occlusion of an inferior vena cava filter due to heparin-induced 
      thrombocytopenia with thrombosis.
PG  - 112-116
LID - 10.1016/j.jccase.2015.12.004 [doi]
AB  - A 50-year-old man developed acute sub-massive pulmonary thromboembolism and 
      proximal deep venous thrombosis. A continuous intravenous infusion of 
      unfractionated heparin (UFH) was started, and an inferior vena cava (IVC) filter 
      was implanted. He developed symptomatic complete obstruction of the filter 6 days 
      after the initiation of UFH, and he was transferred to our hospital. We started 
      pulse-spray catheter-directed thrombolysis (CDT) with urokinase. However, 
      thrombocytopenia occurred 11 days after the initiation of heparin. We suspected 
      heparin-induced thrombocytopenia (HIT) with thrombosis (HITT), and switched from 
      UFH to argatroban. In addition, we continued pulse-spray CDT. As a result, 
      thrombocytopenia improved and thrombolysis was successful without complications 
      of recurrent thromboembolism or bleeding, leading to retrieval of the IVC filter. 
      The antigen assay for HIT was strongly positive, supporting our diagnosis. In 
      patients with suspected HIT it is important to switch from heparin to an 
      alternative anticoagulant as soon as possible, and pulse-spray CDT with urokinase 
      and argatroban as anticoagulant therapy may be effective treatment for 
      thrombo-occlusions of IVC filters in patients with HITT. <Learning objective: 
      Thrombo-occlusion is a serious complication of inferior vena cava filters. 
      Anticoagulant therapy alone is not effective for dissolving thrombo-occlusions of 
      inferior vena cava filters. In patients with heparin-induced thrombocytopenia 
      with thrombosis, pulse-spray catheter-directed thrombolysis with urokinase and 
      argatroban as anticoagulant therapy may be effective treatment for venous 
      thrombo-occlusion.>.
FAU - Ogihara, Yoshito
AU  - Ogihara Y
AD  - Department of Cardiology and Nephrology, Mie University Graduate School of 
      Medicine, Tsu, Mie, Japan.
FAU - Yamada, Norikazu
AU  - Yamada N
AD  - Department of Cardiology and Nephrology, Mie University Graduate School of 
      Medicine, Tsu, Mie, Japan.
FAU - Matsuda, Akimasa
AU  - Matsuda A
AD  - Department of Cardiology and Nephrology, Mie University Graduate School of 
      Medicine, Tsu, Mie, Japan.
FAU - Ota, Satoshi
AU  - Ota S
AD  - Department of Cardiology and Nephrology, Mie University Graduate School of 
      Medicine, Tsu, Mie, Japan.
FAU - Ito, Masaaki
AU  - Ito M
AD  - Department of Cardiology and Nephrology, Mie University Graduate School of 
      Medicine, Tsu, Mie, Japan.
LA  - eng
PT  - Journal Article
DEP - 20160122
PL  - Japan
TA  - J Cardiol Cases
JT  - Journal of cardiology cases
JID - 101549579
PMC - PMC6280738
OTO - NOTNLM
OT  - Heparin-induced thrombocytopenia
OT  - Pulse-spray catheter-directed thrombolysis
OT  - Thrombo-occlusion of inferior vena filter
EDAT- 2016/01/22 00:00
MHDA- 2016/01/22 00:01
PMCR- 2016/01/22
CRDT- 2018/12/15 06:00
PHST- 2015/09/10 00:00 [received]
PHST- 2015/12/10 00:00 [revised]
PHST- 2015/12/16 00:00 [accepted]
PHST- 2018/12/15 06:00 [entrez]
PHST- 2016/01/22 00:00 [pubmed]
PHST- 2016/01/22 00:01 [medline]
PHST- 2016/01/22 00:00 [pmc-release]
AID - S1878-5409(15)00120-6 [pii]
AID - 10.1016/j.jccase.2015.12.004 [doi]
PST - epublish
SO  - J Cardiol Cases. 2016 Jan 22;13(4):112-116. doi: 10.1016/j.jccase.2015.12.004. 
      eCollection 2016 Apr.