The Successful Prevention of Thromboembolism Using Rivaroxaban in a Patient with Antithrombin Deficiency during the Perioperative Period

Antithrombin (AT) deficiency, a rare disorder of the coagulation system, is a serious risk factor for thromboembolism. Approximately 50-90% of patients with AT deficiency develop thromboembolism during their lifetime. In addition, surgery is a major risk factor for thromboembolism in these patients....

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Bibliographic Details
Published in:Internal Medicine 2017/09/01, Vol.56(17), pp.2339-2342
Main Authors: Kawai, Hidetsugu, Matsushita, Hiromichi, Kawada, Hiroshi, Ogawa, Yoshiaki, Ando, Kiyoshi
Format: Article
Language:English
Subjects:
Aged, 80 and over
Anticoagulants
Anticoagulants - therapeutic use
Antithrombin
antithrombin deficiency
Antithrombin III Deficiency - complications
Antithrombin III Deficiency - drug therapy
Blood Coagulation - drug effects
Case Report
elderly patients
Factor Xa Inhibitors - therapeutic use
Female
Femur
Geriatrics
Humans
Internal medicine
Morpholines - therapeutic use
Older people
Perioperative Period
Risk factors
rivaroxaban
Rivaroxaban - therapeutic use
Surgery
Thromboembolism
Thromboembolism - drug therapy
Thromboembolism - etiology
Treatment Outcome
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Summary:Antithrombin (AT) deficiency, a rare disorder of the coagulation system, is a serious risk factor for thromboembolism. Approximately 50-90% of patients with AT deficiency develop thromboembolism during their lifetime. In addition, surgery is a major risk factor for thromboembolism in these patients. We herein report the case of a 90-year-old woman with AT deficiency who was safely and successfully managed using rivaroxaban (a direct oral factor Xa inhibitor) during the perioperative period of surgery for right femur fracture. The present case illustrates the effectiveness of rivaroxaban in preventing thromboembolisms due to surgery, even in very elderly patients with antithrombin deficiency. Further investigations are needed to determine the optimal dosage of rivaroxaban.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.8487-16