Phlebologie 2011; 40(04): 211-215
DOI: 10.1055/s-0037-1621771
Fallbericht
Schattauer GmbH

Neue Optionen in der Antikoagulation bei therapie -refraktärem Trousseau-Syndrom

New options in anticoagulation in patients with therapy-refractory trousseau's syndrome
J. Beyer-Westendorf
1   UniversitätsGefäßCentrum, Universitätsklinikum Carl Gustav Carus, an der Technischen Universität Dresden
,
S. Werth
1   UniversitätsGefäßCentrum, Universitätsklinikum Carl Gustav Carus, an der Technischen Universität Dresden
› Author Affiliations
Further Information

Publication History

Received:30 June 2011

Accepted:01 July 2011

Publication Date:
30 December 2017 (online)

Zusammenfassung

Was bisher bekannt ist:

Venöse Thrombembolien sind eine häufige und potenziell lebensbedrohliche Komplikati-on für Tumorpatienten, rezidivierende Thrombembolien trotz einer adäquaten Antikoagulation sind nicht ungewöhnlich. Für diese Pa-tienten gibt es bisher noch keine Therapieempfehlungen.

Was dieser Artikel vermitteln soll:

Der Gebrauch von direkten Thrombininhibitoren wie Argatroban oder Dabigatran kann eine mögliche Alternative zur Stabilisierung einer bisher unbehandelbaren Gerinnungsaktivierung darstellen, wenn eine exzessive Thrombingeneration vorhanden ist. Eine Kombinationstherapie mit Antikoagulantien unterschiedlicher Angriffspunkte im Gerinnungssystem (wie niedermolekulare Heparine oder selektive Faktor-Xa-Hemmer zusamen mit direkten Thrombininhibitoren) können bei Patienten mit rezidivierenden Thromboembo-lien eine sinnvolle Alternative über die Standardtherapie hinaus bei darstellen.

Summary

What is already known about the subject:

Venous thromboembolism is a common and potentially life-threatening complication in cancer patients and recurrent VTE despite adequate anticoagulant therapy is not unusual. However, there is no recommended treatment strategy for these patients.

What this paper adds:

The use of direct thrombin inhibitors such as argatroban or dabigatran could be a potential option to stabilize otherwise untreatable coagulation activation, if excessive thrombin generation is present. Combination therapy with differently acting anticoagulants (such as low-molecular weight heparins or selective factor Xa-inhibitors together with direct thrombin inhibitors) may be beneficial in situations of recurrent VTE despite adequate standard therapy.

 
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