Venous thromboses in particular organs

Case report: A case of renal arcuate vein thrombosis successfully treated with direct oral anticoagulants

A rare case of a 35 years old woman presented with renal arcuate vein thrombosis (RAVT) and acute kidney injury (AKI) following upper respiratory tract symptoms and toxic substance ingestion. Histopathological evaluation of the patient's kidney tissue indicated a rare venous thrombosis in the renal arcuate veins. Anticoagulation with Apixaban, a direct oral anticoagulant (DOAC), was commenced, and the patient's symptoms resolved during the hospital stay. Hitherto, a limited number of studies have shown the concurrent presentation of RAVT and overt AKI in patients following ingestion of nephrotoxic agents. Further studies are necessary to elucidate the etiology, clinical presentation, and treatment of RAVT. We suggest that Apixaban be studied as a suitable alternative to conventionally used anti-coagulants such as Warfarin in patients who lack access to optimal health care facilities.

Pharmacology of heparin and warfarin

Thromboembolic obstruction to three major components of the circulation--arterial, venous and intravascular foreign surfaces--contributes to premature death and disability in Western society. In many, but not all, of these conditions associated with thromboembolism, heparin and warfarin are the drugs of choice. It is the purpose of this presentation to provide some common ground in the area of anticoagulant prophylaxis that will be of intrinsic value for decision making in cardiac, cerebral and peripheral vascular disease. Only those aspects of the hemostatic mechanism most relevant to the antithrombotic action of heparin and warfarin are discussed. Assays for both drugs as well as some practical guidelines for their use in low, medium and high dose regimens are outlined. Techniques for improving the benefit/risk ratio for each drug are specifically detailed.