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肝素诱导的血小板减少症伴腹主动脉覆膜支架急性血栓形成。

Heparin-induced thrombocytopenia with abdominal aortic stent-graft acute thrombosis.

作者信息

Canaud Ludovic, Hireche Kheira, Marty-Ané Charles, Alric Pierre

机构信息

Department of Vascular and Thoracic Surgery, Arnaud de Villeneuve Hospital, Montpellier, France.

出版信息

Ann Vasc Surg. 2013 Aug;27(6):801.e5-7. doi: 10.1016/j.avsg.2012.07.027. Epub 2013 May 24.

Abstract

We report a case of heparin-induced thrombocytopenia in a patient on low molecular weight heparin bridge therapy who developed acute abdominal aortic stent-graft thrombosis 1 week after uncomplicated endovascular abdominal aortic aneurysm repair. The diagnosis was confirmed by a computed tomographic scan of the abdomen. The patient was successfully treated by conversion to open repair. The postoperative course was marked by subacute left limb ischemia related to an in vivo cross-reactivity of danaparoid with the heparin immune complex. To our knowledge, this is the first case report of heparin-induced thrombocytopenia with acute abdominal aortic stent-graft thrombosis.

摘要

我们报告了一例接受低分子量肝素桥接治疗的患者发生肝素诱导的血小板减少症的病例,该患者在未出现并发症的血管腔内腹主动脉瘤修复术后1周发生了急性腹主动脉覆膜支架血栓形成。腹部计算机断层扫描证实了诊断。该患者通过转为开放修复成功治疗。术后病程的特点是出现与达那肝素和肝素免疫复合物的体内交叉反应相关的亚急性左下肢缺血。据我们所知,这是第一例关于肝素诱导的血小板减少症伴急性腹主动脉覆膜支架血栓形成的病例报告。

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