Abstract
Heparin is the standard anticoagulant used for patients with cardiovascular disease because of several advantages including rapid onset of effect, ease of titration and monitoring, and rapid reversal with protamine. However, treatment with heparin can lead to severe complication, heparin-induced thrombocytopenia (HIT), the diagnosis and management of which are important. We present a case of HIT, wherein the patient underwent bypass surgery for critical limb ischemia using argatroban. An 83-year-old man with an arterial occlusion in the lower extremity underwent thrombectomy. After the operation, thrombocytopenia developed and arterial occlusions in the lower extremity were observed again. We suspected HIT and began argatroban therapy. Next, we performed left external iliac artery-posterior tibial artery bypass. Thrombosis did not recur and hemorrhagic complications did not develop perioperatively. We successfully managed HIT with critical limb ischemia during the perioperative period using argatroban.
