Intracranial venous infarction and drainage alteration are rare clinical events developing after intracranial operation. Immediate anticoagulation has been recommended to restore the alteration of the intracranial venous drainage. However, for the venous drainage alteration or infarction developed just after intracranial operation, the bleeding tendency induced by the anticoagulation should be considered. We report a case of successfully managed cortical venous infarctions developed immediately after intracranial operation using low molecular weight heparin.
Drainage* ; Hemorrhage ; Heparin, Low-Molecular-Weight* ; Infarction

heparin (UFH), low molecular weight heparin (LMWH), and direct oral anticoagulants (DOACs).METHODS: Precision, linearity, and carryover rate of the CS-5100 while measuring FDP, UFH, and LMWH were validated. Precision and linearity were validated for measurements of DOACs. Results of FDP measurement using CS-5100 were compared to those using the currently used STA-R coagulometer (Diagnostica Stago, France). The reference range of FDP was established. All evaluation procedures were in accordance with Clinical and Laboratory Standards Institute guidelines.RESULTS: CS-5100 displayed good precision, linearity, and carryover rate for measuring FDP, UFH, LMWH, and DOACs. The FDP level measured with the CS-5100 and STA-R coagulometers correlated well. The reference range of FDP with CS-5100 was 0.0 to 3.48 µg/mL.CONCLUSIONS: The CS-5100 coagulometer has acceptable analytical performance in measuring special coagulation parameters. It is suitable for the reliable measurement of plasma FDP and anticoagulant levels in clinical laboratories.]]>
Anticoagulants ; Fibrinogen ; Heparin ; Heparin, Low-Molecular-Weight ; Plasma ; Reference Values

Warfarin-induced skin necrosis is a rare complication caused by transient hypercoagulable state. This state is a result of rapid decline of the protein C activity relative to that of coagulation factor II, IX, and X during initiation of oral anticoagulant therapy. We experienced a case of warfarin-induced skin necrosis involving both breasts in a patient who underwent double valve replacement 1 month before. Warfarin was replaced to a low- molecular weight heparin and the necrotic breast lesion was healed spontaneously. Low-dose warfarin was restarted and gradually increased, after which a low molecular weight heparin discontinued.
Breast ; Heparin ; Heparin, Low-Molecular-Weight ; Humans ; Molecular Weight ; Necrosis* ; Protein C ; Prothrombin ; Skin* ; Warfarin

Heparin-induced thrombocytopenia (HIT) is a serious, immune mediated complication of exposure to unfractionated or low-molecular-weight heparin. Though rare, it is a condition associated with high morbidity and mortality that requires immediate change to alternative anticoagulants for the prevention of life-threatening thrombosis. The direct thrombin inhibitors lepirudin and argatroban are currently licensed for the treatment of HIT. Dabigatran, a novel oral anticoagulant (NOAC) with a similar mechanism of action and effective use in other indications, has recently been proposed as another therapeutic option in cases of HIT. This review serves as an introduction to using dabigatran for this purpose, detailing the clinical aspects of its administration, evidence of its performance compared to other anticoagulants, and the preliminary reports of HIT successfully treated with dabigatran. As the literature on this develops, it will need to include clinical trials that directly evaluate dabigatran against the other NOACs and current treatment options.
Anticoagulants ; Antithrombins ; Dabigatran* ; Heparin, Low-Molecular-Weight ; Mortality ; Thrombocytopenia* ; Thrombosis

The Patient was a 30-year-old woman. Four years previously, the woman had undergone ileectomy for thrombotic ileal erosion. After being discharged, she received regular medical treatment for thrombotic renal hypertension at our Department of Internal Medicine, and eventually her case was diagnosed as a collagen disease. She was dosed up with depressors and aspirins. Two years later, she got married. Next year, she became pregnant, but miscarried. A causal link between collagen disease and miscarriage was suspected. In the same year, she became pregnant for the second time. The administration of low molecular weight heparins was initiated in addtion to doses of aspirin. In the last trimester of pregnancy (In the latter half of pregnancy?), pregnancy-induced hypertension developed. The woman was immediately hospitalized and placed at bed rest. The dose of low molecular weight heparin was increased. She gave birth to a healthy child. This experience taught us that working in closer collaboration between doctors of internal medicine and obstetricians is of vital importance for the health and safety of pregnant women with a collagen disease and successful childbirth.
Pregnancy ; Human Females ; Heparin, Low-Molecular-Weight ; Collagen ; Aspirin

Warfarin-induced skin necrosis is an infrequent complication occurring in individuals under warfarin treatment who have a thrombophilic history or after administration of large loading doses of warfarin particularly without simultaneous initial use of heparin. A 62-year-old lady developed skin necrosis 4 days after initiating warfarin therapy of 5 mg daily without initial co-administration of heparin. The patient had a normal clotting profile. Skin necrosis progressed to eschar formation after cessation of warfarin and heparinization stopped expanding. Warfarin was reintroduced at 2 mg daily, initially together with low molecular weight heparin. Autolytic debridement of the necrotic tissue was followed by healing of the cutaneous deficit by secondary intention. Prompt diagnosis and discontinuation of warfarin are crucial for the prognosis.
Anticoagulants ; Debridement ; Diagnosis ; Heparin ; Heparin, Low-Molecular-Weight ; Humans ; Intention ; Middle Aged ; Necrosis* ; Prognosis ; Skin* ; Warfarin

BACKGROUND AND PURPOSE: The effect of low molecular weight heparin (LMWH) in the management of cerebral venous thrombosis (CVT) remains unclear. The present study was performed to determine the safety and feasibility of subcutaneous LMWH, with particular attention to hemorrhagic conversions. METHODS: LMWH (nadroparin, 7,500 ICU, every 12 hours) was administered subcutaneously for 14 days to 12 patients diagnosed with CVT. Initial clinical manifestations, etiologies and the clinical courses after LMWH treatment were also evaluated. Possible hemorrhagic side effects, including aggravation of the initial hemorrhage and/or newly developed-hemorrhagic conversions were monitored by image analysis. RESULTS: Headaches and convulsive movements were frequent presenting symptoms for CVT. Clinical improvement was usually observed within 2 to 8 days after LMWH. Symptom stabilization was observed within 4 to 60 days. Neither clinical aggravations, nor newly developed parenchymal lesions were observed during LMWH maintenance. Associated parenchymal lesions were observed in 9 of the 12 patients, 5 of which manifested with hemorrhagic conversion, as detected by image analysis. However, no clinical and radiologic aggravation was noted in these 5 patients. CONCLUSIONS: Our results suggest that LMWH may be safe and feasible in the management of CVT.
Headache ; Hemorrhage ; Heparin ; Heparin, Low-Molecular-Weight* ; Humans ; Sinus Thrombosis, Intracranial* ; Venous Thrombosis

Aortic thrombosis is one of the common complications caused by umblical cord catheterization. There are three treatment options for aortic thrombosis:anticoagulation, thrombolysis, surgery. Low-molecular-weight heparin has several advantages over unfractionized heparin in the treatment of thrombosis. However, there is limited experience on using low-molecular-weight heparin in children, especially in the newborns. We experienced a case of aortic thrombosis caused by umbilical cord catheterization, which was successfully treated with low-molecular-weight heparin.
Catheterization* ; Catheters* ; Child ; Heparin ; Heparin, Low-Molecular-Weight* ; Humans ; Infant, Newborn ; Thrombosis* ; Umbilical Cord

BACKGROUND: The anticoagulant efficacy of low molecular weight heparin (LMWH) as an alternative substitute for standard heparin (SH) was evaluated by measuring thrombin-antithrombin complex (TAT) and tissue factor pathway inhibitor (TFPI). METHODS: Twenty-two patients with coronary artery disease (CAD) were divided into three groups and plasma heparin concentration, platelet count, aPTT, TAT and TFPI before and after injection of SH and LMWH were measured. RESULTS: Plasma heparin concentrations were well correlated after the injection of heparin in group B (LMWH 200 U/kg) and C (LMWH 240 U/kg), but not in group A (SH). Platelet counts were not decreased in most patients and life-threatened bleeding was not observed in any patients. APTT prolongations were observed in all patients of SH group, but not in any patients of B and C. TAT levels were not significantly different between groups. TFPI levels were not significantly different between groups. Heparin levels were well correlated with TFPI levels, but not with TAT levels. CONCLUSION: The anticoagulant effect of LMWH up to 240 U/kg/D was not superior over SH in CAD patients, although it has several merits such as no requirement of aPTT monitoring or better predictability.
Coronary Artery Disease* ; Coronary Vessels* ; Hemorrhage ; Heparin ; Heparin, Low-Molecular-Weight* ; Humans ; Plasma* ; Platelet Count ; Thromboplastin*

Objective: To evaluate the efficacy and safety of different bridging anticoagulant therapies in patients undergoing mechanical heart valve replacement (MHVR) surgery. Methods: Consecutive patients undergoing MHVR surgery from January 2018 to December 2018 in First Hospital of Lanzhou University were prospectively enrolled in this study. Patients were divided into unfractionated heparin (UFH) group and low molecular weight heparin (LMWH) group according to the postoperative bridging anticoagulation methods. Preoperative clinical data and postoperative related time and cost parameters, including drainage time, duration of stay in intensive care unit (ICU), postoperative time (interval from end of operation to discharge) and INR stabilization time (interval from start of bridge anticoagulation to INR value reaching the standard for 2 consecutive days) of all enrolled patients were collected, and all patients were followed up for 4 weeks and thromboembolic or bleeding events were analyzed. Multivariate logistic regression was used to determine the independent prognostic factors of thromboembolic or bleeding events after MHVR receiving various bridging anticoagulant therapies. Results: A total of 217 patients were included in the study, including 120 patients in the UFH group and 97 patients in the LMWH group. Stroke occurred in two patients in the UFH group, while no stroke event occurred in the LMWH group. The incidence of bleeding events was significantly higher (9.28%(9/97) vs. 1.67%(2/120), P=0.02), while the drainage time, duration of stay in ICU, postoperative time, INR stabilization time were all significantly shorter in LMWH group than in UFH group (all P<0.05). Multivariate logistic regression analysis showed that bridging anticoagulation therapies (OR=0.18, 95%CI 0.04-0.86, P=0.03), fibrinogen level (OR=1.99, 95%CI 1.16-3.41, P=0.01) and creatinine level (OR=1.05, 95%CI 1.01-1.08, P=0.04) were independent prognostic factors for bleeding events. Conclusion: LMWH use is associated with increased risk of bleeding events, but can significantly reduce the drainage time, duration of stay in ICU, postoperative time, INR stabilization time in patients post MHVR surgery.
Anticoagulants/therapeutic use* ; Heart Valves ; Heparin ; Heparin, Low-Molecular-Weight ; Humans ; Thromboembolism/drug therapy*