Intraoperative Heparin Resistance after Administration of Andexanet Alfa to Manage an Internal Iliac Artery Aneurysm Rupture: A Case Report

Kanetsugu Nagao; Shigeyuki Yamashita; Rina Ebe; Norihito Naruto; Hisakatsu Ito; Saori Nagura; Toshio Doi; Kazuaki Fukahara; Naoki Yoshimura

doi:10.3400/avd.avd.cr.23-00060

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Intraoperative Heparin Resistance after Administration of Andexanet Alfa to Manage an Internal Iliac Artery Aneurysm Rupture: A Case Report

Kanetsugu Nagao , Shigeyuki Yamashita, Rina Ebe, Norihito Naruto, Hisakatsu Ito, Saori Nagura, Toshio Doi, Kazuaki Fukahara, Naoki Yoshimura

著者情報

Kanetsugu Nagao 責任著者
First Department of Surgery, University of Toyama, Toyama, Toyama, Japan
Shigeyuki Yamashita
First Department of Surgery, University of Toyama, Toyama, Toyama, Japan
Rina Ebe
First Department of Surgery, University of Toyama, Toyama, Toyama, Japan
Norihito Naruto
Department of Radiology, University of Toyama, Toyama, Toyama, Japan
Hisakatsu Ito
Department of Anesthesia, University of Toyama, Toyama, Toyama, Japan
Saori Nagura
First Department of Surgery, University of Toyama, Toyama, Toyama, Japan
Toshio Doi
First Department of Surgery, University of Toyama, Toyama, Toyama, Japan
Kazuaki Fukahara
First Department of Surgery, University of Toyama, Toyama, Toyama, Japan
Naoki Yoshimura
First Department of Surgery, University of Toyama, Toyama, Toyama, Japan

キーワード: andexanet alfa, heparin resistance, endovascular aneurysm repair

ジャーナルオープンアクセス早期公開

論文ID: avd.cr.23-00060

DOI https://doi.org/10.3400/avd.avd.cr.23-00060

この記事には本公開記事があります。

The final version of this article is now available: Vol. 16 (2023), No. 4 pp. 273-276

詳細

抄録

Antithrombotic agents are increasingly prescribed to older adults; however, they are associated with bleeding-related complications. We describe a case of intraoperative heparin resistance after administration of andexanet alfa (AA). An 81-year-old man was diagnosed with a ruptured internal iliac artery aneurysm. The patient required emergency endovascular aneurysm repair and was treated with AA because he was receiving apixaban. Despite high-dose intraoperative heparin administration, his activated coagulation time was not prolonged. Our findings suggest that AA should be administered with caution in patients experiencing potentially fatal bleeding (requiring surgical intervention) who are also receiving direct oral anticoagulants.

責任著者(Corresponding author)

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