First use of andexanet alfa in the management of massive delayed hemothorax
Miroslaw Kozlowski1
, Julia Antkiewicz2, Anna Choroszewska2, Krystian Czolpinski2, Pawel Niemynski1
1Department of Thoracic Surgery, Medical University of Bialystok, Białystok, Poland
2Department of Thoracic Surgery, Students’ Scientific Group, Medical University of Bialystok, Białystok, Poland
Keywords: Andexanet alfa, delayed hemothorax, massive hemothorax
Abstract
In emergency medicine practice, massive hemothorax represents a life threatening condition in patients with comorbidities. We present the case of a 75 year old female patient with a massive delayed hemothorax, which developed following a chest injury sustained during a low height fall. The patient had been on long term rivaroxaban, a direct oral anticoagulant, due to underlying comorbid conditions. To reverse the anticoagulant effect, andexanet alfa was administered, followed by the placement of chest drainage. After evacuating the bloody pleural effusion from the pleural cavity, full lung reexpansion was achieved, with only minimal residual drainage within an hour. Following drainage removal, the patient was subsequently discharged without any complications. After follow up, the patient remained in good condition. This case demonstrates that andexanet alfa can be an effective reversal agent in life threatening cases of massive delayed hemothorax.
How to cite this article: Kozlowski M, Antkiewicz J, Choroszewska A, Czolpinski K, Niemynski P. First use of andexanet alfa in the management of massive delayed hemothorax. Turk J Emerg Med 2026;26:71-4.
The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given her consent for her images and other clinical information to be reported in the journal. The patient understands that her name and initials will not be published and due efforts will be made to conceal her identity, but anonymity cannot be guaranteed.
MK: Conceptualization (lead), Supervision (lead), Project administration (lead), Writing ‑ review and editing (equal), Investigation(lead), Resources (lead). JA: Writing ‑ original draft(equal), Writing ‑ review and editing (equal), Project administration (equal), Visualization (equal). AC: Writing ‑ original draft (equal), Writing ‑ review and editing (equal), Project administration (equal), Visualization (equal). KC: Writing ‑ original draft (equal), Writing ‑ review and editing (equal), Project administration (equal), Visualization (equal). PN: Project administration (supporting), Resources (supporting), Investigation (supporting).
None Declared.
None.