Difficult Intraoperative Heparinization Following Andexanet Alfa Administration
General Material Designation
[Article]
First Statement of Responsibility
Watson, C. James; Zettervall, Sara L.; Hall, Matthew M.; Ganetsky, Michael
SUMMARY OR ABSTRACT
Text of Note
Direct oral anticoagulants are now commonplace, and reversal agents are recently becoming available. Andexanet alfa (AnXa), approved by the United States Food and Drug Administration in 2018, is a novel decoy molecule that reverses factor Xa inhibitors in patients with major hemorrhage. We present a case of a 70-year-old man taking rivaroxaban with hemodynamic instability from a ruptured abdominal aortic aneurysm. He received AnXa prior to endovascular surgery, and intraoperatively he could not be heparinized for graft placement. Consideration should be given to the risks and benefits of AnXa administration in patients who require anticoagulation after hemorrhage has been controlled.
SET
Date of Publication
2019
Title
Clinical Practice and Cases in Emergency Medicine
Volume Number
3/4
PERSONAL NAME - PRIMARY RESPONSIBILITY
Entry Element
Watson, C. James; Zettervall, Sara L.; Hall, Matthew M.; Ganetsky, Michael