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

  • 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

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.

 

 

Published
Aug 8, 2016
How to Cite
ANGHELESCU, Aurelian. 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. International Archives of Medicine, [S.l.], v. 9, aug. 2016. ISSN 1755-7682. Available at: <http://imed.pub/ojs/index.php/iam/article/view/1747>. Date accessed: 20 nov. 2017. doi: http://dx.doi.org/10.3823/2035.
Section
Cardiology

Keywords

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