2020 Apr 15. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan

Bivalirudin is an inhibitor of thrombin, an essential factor within the coagulation cascade crucial to thrombus formation.

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Bivalirudin is a direct thrombin inhibitor (DTI) with specific actions indicated for intravenous (IV) anticoagulation in patients with acute myocardial infarction, unstable angina, percutaneous coronary intervention (PCI), and thrombosis in patients with a history of heparin-induced thrombocytopenia (HIT). More recently, bivalirudin has been explored and utilized off label, in patients undergoing cardiopulmonary bypass and extracorporeal membrane oxygenation and for deep venous thrombosis prophylaxis (ECMO).