Q: 72 years old male is admitted to ICU with CVA. Urology service is consulted for urinary catheter insertion. After evaluation they recommend ureteral stent. On reviewing the chart, you note that patient has a diagnosis of Heparin Induced Thrombocytopenia (HIT) in the chart. What advise should be shared with urology service?


Answer:  Avoid stent with heparin coating

Different commercial ureteral stents are available with coating of hydrogel, heparin, silver nitrate, or ofloxacin. In patients, with diagnosis it is advisable to avoid any type of exposure to heparin if there is no absolute need.


References:

1. Riedl CR, Witkowski M, Plas E, Pflueger H. Heparin coating reduces encrustation of ureteral stents: a preliminary report. Int J Antimicrob Agents 2002; 19:507. 

2. Tenke P, Riedl CR, Jones GL, et al. Bacterial biofilm formation on urologic devices and heparin coating as preventive strategy. Int J Antimicrob Agents 2004; 23 Suppl 1:S67.