Journal of thrombosis and thrombolysis
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J. Thromb. Thrombolysis · May 2018
Prothrombin complex concentrate for reversal of direct factor Xa inhibitors prior to emergency surgery or invasive procedure: a retrospective study.
Direct oral factor Xa (FXa) inhibitors are widely used for anticoagulation but a targeted antidote is not available. Four-factor prothrombin complex concentrate (4FPCC) has been shown in observational studies to support hemostasis in most patients with major bleeding related to FXa inhibitors with an acceptable rate of thromboembolic events. However, the effectiveness of 4FPCC for reversal of FXa inhibitors prior to emergency surgery or invasive procedures is unclear. ⋯ The all-cause mortality rate was 28.6%; 2/3 of these patients had an intracranial hemorrhage. Hemostasis was rated as good in most patients with no thromboembolic events observed. Prospective studies assessing the safety and effectiveness of 4FPCC for this indication are needed.