| Comparison of the effect of intra-arterial versus intravenous heparin on radial artery occlusion after transradial catheterization. | |
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MedLine Citation:
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PMID: 19801029 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Radial artery occlusion (RAO) is an infrequent, asymptomatic, complication of transradial catheterization and probably 1 of the few. Intravenous heparin and patent hemostasis lower its incidence. A possible local effect of intra-arterially administered heparin during transradial procedures has not been evaluated. We studied 500 consecutive patients randomized to an intravenous group (n = 250), receiving 50 U/kg of unfractionated heparin (maximal dose 5,000 U) intravenously, and an intra-arterial group (n = 250) receiving the same dose intra-arterially. All patients received a vasodilator "cocktail" intra-arterially and underwent cardiac catheterization using a 5F introducer sheath and catheters. The activated clotting time was measured at the end of the procedure. All patients received hemostasis with a radial compression device (TR Band), applied after sheath removal, for 2 hours. A plethysmographic evaluation for RAO was performed at 24 hours and 30 days after the procedure. Early RAO occurred in 5.6% (n = 14) of the intravenous group and 6% (n = 15) of the intra-arterial group. The difference was not statistically significant (chi-square = 0.037, p >0.8). Chronic RAO occurred in 3.2%, (n = 8) of the intravenous group compared to 4% (n = 10) of the intra-arterial group. The difference was not statistically significant (chi-square = 0.231, p >0.6). The activated clotting time was 211 +/- 16 seconds in the intravenous group and 213 +/- 17 seconds in the intra-arterial group, a statistically insignificant difference (t = -1.095, p >0.2). In conclusion, intra-arterial and intravenous heparin administration provide comparable efficacy in preventing RAO, favoring a probable systemically mediated mechanism of action, rather than a local effect. |
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Authors:
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Samir B Pancholy |
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Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial Date: 2009-08-25 |
Journal Detail:
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Title: The American journal of cardiology Volume: 104 ISSN: 1879-1913 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-10-05 Completed Date: 2009-10-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1083-5 Citation Subset: AIM; IM |
Affiliation:
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Mercy Hospital and Community Medical Center, Scranton, Pennsylvania, USA. drpancholy@yahoo.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anticoagulants
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administration & dosage* Arterial Occlusive Diseases / drug therapy*, etiology Catheterization, Peripheral / adverse effects* Coronary Angiography / methods* Female Follow-Up Studies Heparin / administration & dosage* Humans Injections, Intra-Arterial Injections, Intravenous Male Middle Aged Radial Artery* Retrospective Studies Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants; 9005-49-6/Heparin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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