Secondary Prevention of Systemic Arterial and Recurrent Venous Thromboembolic Events, Through Extended Time Anticoagulation with Apixaban, in an Elderly Patient with Multiple Comorbidities, Clinical Case

Authors

  • Aurelian Anghelescu Teaching Emergency Hospital "Bagdasar-Arseni", Berceni Av., No.12, postal code: 041915, 4th Sector, Bucharest, Romania; Tel: +4021/ 3343025 (6,7)/ 1003 http://orcid.org/0000-0002-8055-0541

DOI:

https://doi.org/10.3823/2035

Keywords:

Thromboprophylaxis, deep vein thrombosis, vitamin K antagonist (acenocumarol), novel/ target-specific/ direct oral anticoagulant (NOACs, TSOAs, DOACs), stroke sequelae

Abstract

The clinical case illustrates the daily practice with an individualized, adjusted thromboprophylactic  dose of apixaban (2.5 mg twice-daily, follow-up for 20 months), mandatory indicated as a continuous therapy for secondary prevention of systemic arterial embolism and recurrent venous thromboembolic events, in an elderly obese patient, associating multiple pathological conditions (chronically anticoagulated for non valvular atrial fibrillation and stroke sequelae, multiple metabolic comorbidities such as type 2 diabetes mellitus , hyperuricemia, moderate renal insufficiency, hyperuricemia), who submitted a severe “unprovoked†phlegmasia alba dolens in the sound (left) lower limb, a decade after a (most possible) iatrogenic deep vein thrombosis at the paralyzed (right) limb.

Thromboprophylaxis for an extended time, without any medical complications (neither systemic or venous thrombotic events, nor hemorrhagic ones) confirmed the product`s efficacy and safety profile. Physiopathological considerations and essential pharmacological considerations were discussed, focused on the individualized safe therapeutic approach.

 

 

Author Biography

Aurelian Anghelescu, Teaching Emergency Hospital "Bagdasar-Arseni", Berceni Av., No.12, postal code: 041915, 4th Sector, Bucharest, Romania; Tel: +4021/ 3343025 (6,7)/ 1003

Neurorehabilitation Clinic

Prime Vice-President of the Romanian Society for Neurorehabilitation (RoSNeRa) - affiliated to the World Federation for Neurorehabilitation (WFNR)

Prime Vice-President of the Romanian Spinal Cord Society (RoSCoS) - affiliated to the International Spinal Cord Society (ISCoS) and to the European Spinal Cord Injury Federation (ESCIF)

 

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Published

2016-08-08

Issue

Section

Cardiology

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