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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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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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creator	Kawai, Hidetsugu Matsushita, Hiromichi Kawada, Hiroshi Ogawa, Yoshiaki Ando, Kiyoshi
description	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.
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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. 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Med.</addtitle><description>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.</description><subject>Aged, 80 and over</subject><subject>Anticoagulants</subject><subject>Anticoagulants - therapeutic use</subject><subject>Antithrombin</subject><subject>antithrombin deficiency</subject><subject>Antithrombin III Deficiency - complications</subject><subject>Antithrombin III Deficiency - drug therapy</subject><subject>Blood Coagulation - drug effects</subject><subject>Case Report</subject><subject>elderly patients</subject><subject>Factor Xa Inhibitors - therapeutic use</subject><subject>Female</subject><subject>Femur</subject><subject>Geriatrics</subject><subject>Humans</subject><subject>Internal medicine</subject><subject>Morpholines - therapeutic use</subject><subject>Older people</subject><subject>Perioperative Period</subject><subject>Risk factors</subject><subject>rivaroxaban</subject><subject>Rivaroxaban - therapeutic use</subject><subject>Surgery</subject><subject>Thromboembolism</subject><subject>Thromboembolism - drug therapy</subject><subject>Thromboembolism - etiology</subject><subject>Treatment Outcome</subject><issn>0918-2918</issn><issn>1349-7235</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNplkV1v0zAUhiMEYmXwF5AlbrjJ8EcSxzdI04CBNGkVdNeW4xw3rlK72E5h_4CfPYeWCsaFj2Wd5z0ffosCEXxBSSPeWZcgODVuobfaOrhoq5aXpHlSLAirRMkpq58WCyxIW9IczooXMW4wZi0X9HlxRvNdMY4Xxa_VAOjbpDXEaKYRLQPswSXrHfIGrYbgt52HfEYbt-guWrdGX-1eBf9Tdcoh65BCS5VsFqEfNg3oMqvTb13OfQCTBwSn71E_hVmccr8lBOt3ELJsf3z1L4tnRo0RXh3v8-Lu08fV1efy5vb6y9XlTakbglNZ6zb37VktWF-bvhcUSM8NqaAR2hhoiRZYMWMMFlXf4o5XDIShhnQ1rnnDzov3h7q7qcvfp_PcQY1yF-xWhXvplZX_Zpwd5NrvZd2wmhGSC7w9Fgj--wQxya2NGsZROfBTlERQ3lKBOc_om0foxk-zb1FSTKqa0oa3mWoPlA4-xgDmNAzBcrZbPrZbznZLMi_z-u9lTsI__mbg9gBsYlJrOAEqJKtH-L9y3UjC53hscSL1oIIExx4AjC_Nzw</recordid><startdate>20170101</startdate><enddate>20170101</enddate><creator>Kawai, Hidetsugu</creator><creator>Matsushita, Hiromichi</creator><creator>Kawada, Hiroshi</creator><creator>Ogawa, Yoshiaki</creator><creator>Ando, Kiyoshi</creator><general>The Japanese Society of Internal Medicine</general><general>Japan Science and Technology Agency</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20170101</creationdate><title>The Successful Prevention of Thromboembolism Using Rivaroxaban in a Patient with Antithrombin Deficiency during the Perioperative Period</title><author>Kawai, Hidetsugu ; Matsushita, Hiromichi ; Kawada, Hiroshi ; Ogawa, Yoshiaki ; Ando, Kiyoshi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c610t-5c8abad3593d5fdd92e1d7f14e69cffe81c90a3fff094d80b743e9f2f1b505763</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged, 80 and over</topic><topic>Anticoagulants</topic><topic>Anticoagulants - therapeutic use</topic><topic>Antithrombin</topic><topic>antithrombin deficiency</topic><topic>Antithrombin III Deficiency - complications</topic><topic>Antithrombin III Deficiency - drug therapy</topic><topic>Blood Coagulation - drug effects</topic><topic>Case Report</topic><topic>elderly patients</topic><topic>Factor Xa Inhibitors - therapeutic use</topic><topic>Female</topic><topic>Femur</topic><topic>Geriatrics</topic><topic>Humans</topic><topic>Internal medicine</topic><topic>Morpholines - therapeutic use</topic><topic>Older people</topic><topic>Perioperative Period</topic><topic>Risk factors</topic><topic>rivaroxaban</topic><topic>Rivaroxaban - therapeutic use</topic><topic>Surgery</topic><topic>Thromboembolism</topic><topic>Thromboembolism - drug therapy</topic><topic>Thromboembolism - etiology</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kawai, Hidetsugu</creatorcontrib><creatorcontrib>Matsushita, Hiromichi</creatorcontrib><creatorcontrib>Kawada, Hiroshi</creatorcontrib><creatorcontrib>Ogawa, Yoshiaki</creatorcontrib><creatorcontrib>Ando, Kiyoshi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Internal Medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kawai, Hidetsugu</au><au>Matsushita, Hiromichi</au><au>Kawada, Hiroshi</au><au>Ogawa, Yoshiaki</au><au>Ando, Kiyoshi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Successful Prevention of Thromboembolism Using Rivaroxaban in a Patient with Antithrombin Deficiency during the Perioperative Period</atitle><jtitle>Internal Medicine</jtitle><addtitle>Intern. Med.</addtitle><date>2017-01-01</date><risdate>2017</risdate><volume>56</volume><issue>17</issue><spage>2339</spage><epage>2342</epage><pages>2339-2342</pages><issn>0918-2918</issn><eissn>1349-7235</eissn><notes>ObjectType-Case Study-2</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-4</notes><notes>content type line 23</notes><notes>ObjectType-Report-1</notes><notes>ObjectType-Article-3</notes><notes>Correspondence to Dr.　Hiromichi Matsushita, hirommat@ncc.go.jp</notes><abstract>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.</abstract><cop>Japan</cop><pub>The Japanese Society of Internal Medicine</pub><pmid>28794370</pmid><doi>10.2169/internalmedicine.8487-16</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record>
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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
title	The Successful Prevention of Thromboembolism Using Rivaroxaban in a Patient with Antithrombin Deficiency during the Perioperative Period
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