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{
    "pk": 738,
    "title": "Difficult Intraoperative Heparinization Following Andexanet Alfa Administration",
    "subtitle": null,
    "abstract": "Direct oral anticoagulants are now commonplace, and reversal agents are recently becoming available. Andexanet alfa (AnXa), approved by the United States Food and Drug Administration in 2018, is a novel decoy molecule that reverses factor Xa inhibitors in patients with major hemorrhage. We present a case of a 70-year-old man taking rivaroxaban with hemodynamic instability from a ruptured abdominal aortic aneurysm. He received AnXa prior to endovascular surgery, and intraoperatively he could not be heparinized for graft placement. Consideration should be given to the risks and benefits of AnXa administration in patients who require anticoagulation after hemorrhage has been controlled.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [],
    "section": "Case Reports",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/7x43z9r3",
    "frozenauthors": [
        {
            "first_name": "C.",
            "middle_name": "James",
            "last_name": "Watson",
            "name_suffix": "",
            "institution": "Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Sara",
            "middle_name": "L.",
            "last_name": "Zettervall",
            "name_suffix": "",
            "institution": "Beth Israel Deaconess Medical Center, Division of Vascular and Endovascular Surgery, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Matthew",
            "middle_name": "M.",
            "last_name": "Hall",
            "name_suffix": "",
            "institution": "Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Michael",
            "middle_name": "",
            "last_name": "Ganetsky",
            "name_suffix": "",
            "institution": "Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, Massachusetts",
            "department": "None"
        }
    ],
    "date_submitted": "2019-10-15T03:52:52+02:00",
    "date_accepted": "2019-10-15T03:52:52+02:00",
    "date_published": "2019-10-15T03:53:51+02:00",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "",
            "path": "https://journalpub.escholarship.org/uciem_cpcem/article/738/galley/493/download/"
        }
    ]
}