Start therapy with lepirudin, argatroban, or danaparoid.
HITT
is life-threatening, and correct management is critical. In addition to
stopping heparin, therapy must be initiated with a drug that acts
directly on thrombin. Use of warfarin can increase the risk of venous
limb gangrene and is not an acceptable option. There are no clinical
data to support the use of tissue plasminogen activator therapy.
Whereas the risk for HITT is less with LMWH than with unfractionated
heparin, cross-reactivity can occur. As a result, LMWH is
contraindicated in patients with HITT.
