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Andexanet for factor Xa inhibitor-associated acute intracerebral hemorrhage.
CJEM
January 2025
Canadian Association of Emergency Physicians Critical Care Committee, Ottawa, ON, Canada.
Anticoagulation Reversal in Intracerebral Hemorrhage: A Case Report on the Efficacy of Andexanet Alfa in an Apixaban-Treated Patient.
Cureus
November 2024
Neurosurgery, County Clinical Emergency Hospital of Sibiu, Sibiu, ROU.
Intracerebral hemorrhage (ICH) presents complex clinical challenges, particularly in patients receiving anticoagulation therapy. This case report discusses the management of acute ICH in a 60-year-old male patient on long-term apixaban therapy, who arrived at the emergency department with altered consciousness, right-sided hemiplegia, and mixed aphasia. Computed tomography (CT) imaging revealed a 70 ml left lenticular-capsular hematoma with significant mass effect, necessitating rapid intervention.
View Article and Find Full Text PDFTroubleshooting heparin resistance.
Hematology Am Soc Hematol Educ Program
December 2024
Departments of Anesthesiology, Critical Care, and Surgery, Duke University School of Medicine, Durham, NC.
Article Synopsis
The Efficacy of Andexanet Alfa for the Reversal of Factor Xa Inhibitors Is Not Influenced by Hemodilution with Different Volume Expanders.
J Clin Med
November 2024
Department of Anesthesiology, University Hospital RWTH Aachen, 52074 Aachen, Germany.
Andexanet alfa is a specific antidote for factor Xa (FXa) inhibitors. It is licensed to treat patients under FXa inhibitor therapy with life-threatening bleeding. Concomitantly, volume expanders are used to compensate for blood loss and maintain circulation.
View Article and Find Full Text PDFAndexanet Alfa-Associated Heparin Resistance in Cardiac Surgery: Mechanism and In Vitro Perspectives.
Arterioscler Thromb Vasc Biol
January 2025
Division of Cardiothoracic Anesthesiology, Department of Anesthesiology and Critical Care, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.K., N.K.T.).
Background: Andexanet alfa (andexanet) is the only Food and Drug Administration-approved antidote for direct FXa (factor Xa) inhibitors but has been reported to cause resistance to unfractionated heparin (UFH). This has delayed anticoagulation for procedures requiring cardiopulmonary bypass. The mechanism, andexanet and UFH dose dependence, and thrombotic risk of andexanet-associated heparin resistance are unknown.
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