Difficult Intraoperative Heparinization Following Andexanet Alfa Administration

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...

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Published in:Clinical practice and cases in emergency medicine 2019-10, Vol.3 (4), p.390-394
Main Authors: Watson, C. James, Zettervall, Sara, Hall, Matthew, Ganetsky, Michael
Format: Article
Language:English
Subjects:
Aneurysms
Anticoagulants
Case Report
Emergency medical care
FDA approval
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description 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.
doi_str_mv 10.5811/cpcem.2019.9.43650
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subjects Aneurysms
Anticoagulants
Case Report
Emergency medical care
FDA approval
title Difficult Intraoperative Heparinization Following Andexanet Alfa Administration
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