NYMC Faculty Publications

An Institutional Report of Heparin Induced Thrombocytopenia Type II in Aneurysmal Subarachnoid Hemorrhage Patients

Authors

Boyi Li, Department of Neurosurgery, Westchester Medical Center, New York Medical College, Valhalla, NY 10595, United States.
Tolga Sursal, Department of Neurosurgery, Westchester Medical Center, New York Medical College, Valhalla, NY 10595, United States.
Erick Martinez, School of Medicine, New York Medical College, Valhalla, NY 10595, United States.
Zafar Karimov, School of Medicine, New York Medical College, Valhalla, NY 10595, United States.
Eric Feldstein, Department of Neurosurgery, Westchester Medical Center, New York Medical College, Valhalla, NY 10595, United States.
Alan Stein, Department of Neurosurgery, Westchester Medical Center, New York Medical College, Valhalla, NY 10595, United States.
Jared Cooper, Department of Neurosurgery, Westchester Medical Center, New York Medical College, Valhalla, NY 10595, United States.
Rasheed Hosein-Woodley, School of Medicine, New York Medical College, Valhalla, NY 10595, United States.
Aiden Liu, School of Medicine, New York Medical College, Valhalla, NY 10595, United States.
Matthew McIntyre, Department of Neurosurgery, Oregon Health and Sciences University, Portland, Oregon 97239, United States.
Christian Bowers, Department of Neurosurgery, University of New Mexico, Albuquerque, New Mexico 87131, United States.
Simon Hanft, Department of Neurosurgery, Westchester Medical Center, New York Medical College, Valhalla, NY 10595, United States.
Zeeshan Hafeez, Department of Neurosurgery, Westchester Medical Center, New York Medical College, Valhalla, NY 10595, United States.
Jared Pisapia, Department of Neurosurgery, Westchester Medical Center, New York Medical College, Valhalla, NY 10595, United States.
Carrie Muh, Department of Neurosurgery, Westchester Medical Center, New York Medical College, Valhalla, NY 10595, United States.
Rachana Tyagi, Department of Neurosurgery, Westchester Medical Center, New York Medical College, Valhalla, NY 10595, United States.
Stephan A. Mayer, Department of Neurosurgery, Westchester Medical Center, New York Medical College, Valhalla, NY 10595, United States.
Chirag D. Gandhi, Department of Neurosurgery, Westchester Medical Center, New York Medical College, Valhalla, NY 10595, United States.
Fawaz Al-Mufti, Department of Neurosurgery, Westchester Medical Center, New York Medical College, Valhalla, NY 10595, United States.

Author Type(s)

Student, Resident/Fellow, Faculty

Journal Title

Interventional Neuroradiology

First Page

363

Last Page

370

Document Type

Article

Publication Date

8-1-2023

Department

Neurosurgery

Second Department

Neurology

Abstract

BACKGROUND: Heparin induced thrombocytopenia Type II (HIT-II) is a dangerous thromboembolic complication of heparin therapy. The current literature on incidence and outcomes of HIT-II in aneurysmal subarachnoid hemorrhage (aSAH) patients remains sparse. OBJECTIVE: We report our institution's incidence and outcomes of HIT-II in aSAH patients. METHODS: We performed a retrospective cohort study at an academic medical center between June 2014 and July 2018. All patients had aSAH confirmed by digital subtraction angiography. Diagnosis of HIT-II was determined by positive results on both heparin PF4-platelet antibody ELISA (anti-PF4) and serotonin release assay (SRA). RESULTS: 204 patients met inclusion criteria. Seven patients (7/204, 3.5%) underwent laboratory testing, three of whom met clinical criteria. HIT-II incidence was confirmed in two of these seven patients (2/204, 0.98%), who had high BMI and T4 scores. CONCLUSION: Our institution's report of HIT-II incidence in aSAH patients is lower than previously reported in this population and more closely parallels HIT-II incidence in the general and surgical ICU setting. Widely-accepted American College of Chest Physicians (ACCP) clinical diagnostic criteria in conjunction with anti-PF4 and SRA testing is the gold standard of clinical diagnosis of HIT-II in aSAH patients.

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