Document Detail


Comparison of the effect of intra-arterial versus intravenous heparin on radial artery occlusion after transradial catheterization.
MedLine Citation:
PMID:  19801029     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Samir B Pancholy
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2009-08-25
Journal Detail:
Title:  The American journal of cardiology     Volume:  104     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-05     Completed Date:  2009-10-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1083-5     Citation Subset:  AIM; IM    
Affiliation:
Mercy Hospital and Community Medical Center, Scranton, Pennsylvania, USA. drpancholy@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Anticoagulants / 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:
0/Anticoagulants; 9005-49-6/Heparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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