Competing Interests: A Case Report of Thoracic Epidural Management and Cangrelor Anticoagulation in a Critically Ill Patient.

Abstract

Management of neuraxial catheters mandates consideration of comorbid conditions requiring anticoagulation, which may complicate their management. Cangrelor is an intravenous P2Y12 inhibitor with a plasma half-life of 3 to 6 minutes. Its use is indicated to reduce the risk of stent thrombosis. We present a case of a patient with an epidural catheter in situ who became critically ill, requiring antiplatelet therapy with cangrelor. We discuss pertinent considerations of neuraxial techniques in patients requiring cangrelor therapy and review existing guidelines for the management of these patients as well as current evidence of the use of platelet function tests in this setting.