What would be your preferred anticoagulant for recurrent DVT/PE in a patient on hemodialysis with calciphylaxis and prior DOAC failure?
Has significant obesity (>100 kg) with prior DOAC failure. Would you consider subcutaneous heparin in this case? Is there a role for trialing a different DOAC? Would the risks still favor warfarin despite calciphylaxis?
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What anticoagulants would you consider in a patient with ESRD, calciphylaxis, and obesity for recurrent VTE?
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1 Answer
Mednet MemberInvited Expert
Hematology · Medical University of South Carolina
Answered on
A truly complex case: recurrent DVT/PE in the setting of ongoing risk factors for both VTE (active calciphylaxis, prior DOAC failure, and obesity) and bleeding (ESRD on hemodialysis), each of which constrains a different anticoagulant option. Given the complexity and rarity of this case, recommendat...
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