Lower limb revascularization in patients with heparin-induced thrombocytopenia

Abstract

Heparin-induced thrombocytopenia (HIT) is a serious complication which occurs in patients treated with heparin. It is estimated that in clinical practice this syndrome can be encountered among 1-3% of patients who receive heparin treatment. This disease is often not diagnosed. The aim of this study was to evaluate the treatment of patients with diagnosed HIT syndrome who were qualified to revascularisation in the course of critical lower limb ischaemia. There were two cases of patients with diagnosed HIT syndrome who were treated in the Department of General and Vascular Surgery in Poznań. The results of revascular treatment of patients with diagnosed HIT syndrome were evaluated retrospectively. In all patients it was possible to perform revascular surgery of lower limbs after introducing an oral anticoagulant. In 2004 it was impossible to treat HIT syndrome with new generation anticoagulants. That is why oral anticoagulant (coumarin) treatment was introduced as a safe method and the only one available in our conditions. It enabled us to perform revascular surgery retaining INR indicator of 1.5-1.7.