The paradox of heparin-induced thrombocytopenia: future anticoagulation.

Abstract

Heparin and low molecular weight heparin agents are frequently administered to postoperative orthopedic patients. In patients with a history of heparin-induced thrombocytopenia, alternative anticoagulant agents to heparin for prophylaxis and treatment must be considered. Unfortunately, the data is limited in this patient population. Upon transitioning from heparin-induced thrombocytopenia treatment with direct thrombin inhibitors, argatroban, or lepirudin, careful consideration must be taken to avoid further thrombotic complications.