Volumen: 6 # Number : 2
Publication Date : Mayo - Agosto Year: 2002
CONTROVERSIAS EN HEMOSTASIA Y TROMBOSIS |
Authors: Jose Ceresetto, Beatriz Grand, Alberto Maneyro
Abstract: Aticoagulation in atipical venous thrombosis: Cerebral venous thrombosis: there is good evidence to suggest that heparin is not only effective but also safe even in the presence of intracerebral hemorrhages. The duration of heparin therapy is between 2 to 4 weeks and then switched to warfarin for 3 to 6 months. Thrombolytic agents are indicated in case of progression under heparin treatment. Acute Portal or Mesenteric veins thrombosis needs anticoagulation with heparin until the clinical situation is stable. If there is evidence of intestinal ischemia, emergency surgery is warranted. Thrombophilic stales investigation is necesary only when no local predisponding conditions are found. Central retinal vein occlusion doesn't need anticoagulation in most cases, specially in > 55 years old patients with predisposing factors like hypertension, diabetes, hyperlipemia and glucoma. Thrombophilic test must be performed in < 55 years old patients, with schemic retinal vein thrombosis, and in patients with a history of thrombosis. Test must include fasting homosystein level, anticardiolipin antibody, lupus anticoagulant and actived protein C resistance. Acute renal vein thrombosis should recive heparin even if the patients has gross hematuria. Duration of anticoagulant treatment is longlasting if the patients has nephrotic syndrome. Thrombolysis only is recomended if there is bilateral vein thrombosis with renal insuffiency or pregression of thrombosis under anticoagulant with heparin.
Key words: thrombosis, unusual sites, anticoagulation
Pages : 47-55
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