Document Detail


Percutaneous coronary intervention in anticoagulated patients via radial artery access.
MedLine Citation:
PMID:  19089936     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To assess safety and feasibility of using radial artery access for percutaneous coronary intervention (PCI) in patients on oral anticoagulation without interrupting therapy. BACKGROUND: The radial artery approach for PCI is intuitively attractive for patients receiving chronic oral anticoagulation with vitamin K antagonists (VKAs) but little data exist concerning feasibility or safety of this approach in this population. The main advantage of this strategy would be to avoid bridging therapy with heparin that increases risk of thrombotic and bleeding events. METHODS: In this prospective observational study, 50 consecutive patients referred for coronary angiography underwent PCI without interrupting oral anticoagulant therapy. The main outcome measures were bleeding and thrombotic complications. RESULTS: The indications for permanent oral anticoagulation were as follows: atrial fibrillation in 62%, mechanical prosthesis in 24%, and venous thromboembolism in 14%. Seventy-two percent were elective cases and 28% presented with acute coronary syndromes. PCI was performed with an INR range of 1.4-3.4 with mean of 2.2 +/- 0.6. Seventy-six percent of the patients were on dual antiplatelet therapy before the procedure. No thrombotic events or excess bleeding were observed at 1 month. Only one patient had a minor hemorrhage 8 days after procedure. CONCLUSIONS: This series suggests that for patients treated with VKAs, the use of radial artery access is feasible and safe for PCI on dual antiplatelet therapy without interrupting oral anticoagulant treatment.
Authors:
Gérard Helft; Grégoire Dambrin; Azfar Zaman; Claude Le Feuvre; Olivier Barthélémy; Farzin Beygui; Xavier Favereau; Jean-Philippe Metzger
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  73     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2008-12-24     Completed Date:  2009-02-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  44-7     Citation Subset:  IM    
Copyright Information:
(c) 2008 Wiley-Liss, Inc.
Affiliation:
Department of Cardiology, Institut de Cardiologie - GH Pitié-Salpétrière, AP-HP, Université Pierre et Marie Curie, Paris, France. gerard.helft@psl.aphp.fr
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Aged
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects,  methods*
Anticoagulants / administration & dosage*,  adverse effects
Coronary Angiography
Coronary Artery Disease / radiography,  therapy*
Drug Administration Schedule
England
Feasibility Studies
Female
France
Hemorrhage / chemically induced
Humans
Male
Middle Aged
Platelet Aggregation Inhibitors / therapeutic use
Prospective Studies
Radial Artery*
Thrombosis / etiology
Time Factors
Treatment Outcome
Vitamin K / antagonists & inhibitors
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Platelet Aggregation Inhibitors; 12001-79-5/Vitamin K
Comments/Corrections
Comment In:
Catheter Cardiovasc Interv. 2009 Jan 1;73(1):48-9   [PMID:  19089937 ]

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


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