Cor Vasa 2021, 63(5):603-607 | DOI: 10.33678/cor.2021.056

(Thrombosis of temporary caval filter in a patient with subacute heparin-induced thrombocytopenia)

Robin Králík

Kardiologická klinika, Kardiocentrum, 3. lékařská fakulta Univerzity Karlovy a Fakultní nemocnice Královské Vinohrady, Praha

The article presents a case report of a patient with idiopathic arterial thrombosis who developed heparin-induced thrombocytopenia (HIT) after heparin treatment and hybrid revascularization. After disappearance of acute thrombocytopenia, the patient was implanted with a temporary caval filter as a prophylaxis of periprocedural embolization in newly diagnosed high venous thrombosis as part of another percutaneous revascularization intervention for progressive arterial limb thrombosis. The occurrence of thrombotic complications in the caval filter and during ongoing anticoagulant therapy with dabigatran is described, pointing to the higher risk of these complications in connection with HIT, the results of small studies that confirm this risk are mentioned. The case report documents a complete regression of caval thrombosis after discontinuation of dabigatran and adjustment of warfarin therapy with a target INR level of 2.0-3.0 in combination with aspirin. Information on the current recommended antithrombotic treatment in patients with HIT is briefly discussed with reference to recent small trials on the effect of NOACs in these patients.

Keywords: Acetylsalicylic acid, Caval filter, Clopidogrel, Fondaparinux, Heparin-induced thrombocytopenia, NOAC, Thrombosis, Warfarin

Received: March 29, 2021; Revised: April 21, 2021; Accepted: April 24, 2021; Published: October 20, 2021  Show citation