Chuter Timothy A M, Pak Laura K, Gordon Roy L, Reilly Linda M, Messina Louis M
Division of Vascular Surgery, University of California, San Francisco, California 94143, USA.
J Endovasc Ther. 2003 Dec;10(6):1087-90. doi: 10.1177/152660280301000610.
To report a case of heparin-induced thrombocytopenia (HIT) complicated by stent-graft thrombosis.
An 82-year-old woman underwent endovascular aortic aneurysm repair using a Zenith stent-graft. She returned 2 weeks later with an occluded graft limb, large quantities of thrombus lining the remainder of the stent-graft, thrombocytopenia, and antiplatelet antibodies. There were no signs of kinking or compression of the graft, nor was there any thrombosis of the native arteries downstream from the occluded graft limb. Thrombolysis restored graft patency. Anticoagulation was induced using hirudin and warfarin. The graft remains patent at 6-month follow-up.
HIT is a rare cause of postoperative endograft thrombosis. In this case, the presumed source of the inciting heparin dosage was the stent-graft itself, which had been soaked in a concentrated heparin solution prior to insertion.
报告一例肝素诱导的血小板减少症（HIT）并发支架移植物血栓形成的病例。
一名82岁女性接受了使用Zenith支架移植物的血管腔内主动脉瘤修复术。两周后她因移植肢体闭塞、支架移植物其余部分内衬大量血栓、血小板减少和抗血小板抗体而复诊。没有移植物扭结或受压的迹象，闭塞的移植肢体下游的原生动脉也没有血栓形成。溶栓恢复了移植物通畅。使用水蛭素和华法林进行抗凝。在6个月的随访中移植物仍保持通畅。
HIT是术后内支架血栓形成的罕见原因。在本病例中，推测引发肝素剂量的来源是支架移植物本身，其在插入前已浸泡在浓缩肝素溶液中。
