Abstract
Objective: Heparin is used routinely for anticoagulation during cerebral angiography and neurointerventional procedures. Heparin-induced thrombocytopenia is an immune-mediated syndrome that results from unfractionated heparin or low molecular weight heparin exposure. It often remains unrecognized and undertreated and can cause local and/or life-threatening thrombosis.
Case presentation: A 73-year-old male presented with a symptomatic right carotid artery stenosis. During intensive medical therapy in the acute stage, waiting for the revascularization of suffered carotid lesion, the patient developed heparin-induced thrombocytopenia. One hundred and thirty-three days after the thrombo-embolic event, the patient received carotid artery stenting without using heparin. Argatroban was used as an alternate to heparin for anticoagulation. Argatroban was given in a loading dosage of 100 mcg/kg followed by an infusion of 6 mcg/kg/min. During the procedure, there were no procedural complications and MRI after the procedure revealed no evidence of any cerebral infarction.
Conclusion: The authors report a safety alternative method of anticoagulation to prevent clot formation during the procedure of carotid artery stenting in a case with heparin-induced thrombocytopenia.
