PMID: 2123154Dec 1, 1990Paper

A new manifestation and treatment alternative for heparin-induced thrombosis

Chest
J A DieckG A Massumi

Abstract

We treated a coronary artery bypass patient whose postoperative course was complicated by heparin-induced thrombocytopenia and resultant pulmonary artery and saphenous vein graft thromboses. The pulmonary thromboemboli were found first, and pulmonary blood flow was restored with intravenously administered tissue plasminogen activator (tPA). A short time later, the vein grafts were found to be occluded, and we subsequently performed multivessel percutaneous transluminal coronary angioplasty (PTCA) using tPA as an adjuvant to oral warfarin sodium therapy with excellent results. We conclude that heparin-induced thromboses in the pulmonary arteries are amenable to thrombolytic therapy, including tPA, whereas this regimen appears to have little effect on saphenous vein grafts. We also found that a combination of warfarin and thrombolytic therapy is an alternative regimen for heparin-intolerant patients who require PTCA.

References

Apr 1, 1988·Mayo Clinic Proceedings·J L AtkinsonJ P Whisnant
Jul 1, 1988·Journal of Vascular Surgery·C W Cole, J Bormanis
Jul 1, 1985·Annals of Internal Medicine·S K KruegerE Weinand
Sep 1, 1985·Archives of Internal Medicine·J I CohenC S Greenberg

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Citations

May 1, 1995·Catheterization and Cardiovascular Diagnosis·B K GuptaA N Brest
Jun 1, 1995·Clinical Cardiology·C R Conti

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