AIMS: To evaluate the feasibility and safety of an anticoagulation adapted regimen for transradial coronary angiography. METHODS AND RESULTS: We randomly assigned 162 consecutive patients who benefited from an elective transradial approach for coronarography to receive either astandard dose of 5,000 IU heparin or 50 IU/kg with an upper limit of 5,000 IU. Patients under anti-vitamin K therapy were excluded. The TRband compression system was employed for the entire population after the procedure. Radial artery patency, the primary endpoint, was evaluated with Doppler before discharge from the hospital. Secondary endpoints were: ACT level immediately before sheath removal, compression length and bleeding complications. Both groups were well matched. ACT level is significantly lower in the adjusted anticoagulation group (231.4 min, vs. 265.6 min, p<10-4). Radial compression time was higher in the standard protocol group (235.5 min, vs. 204.5 min, p<10-5). No radial occlusion was noted, whatever the group considered. Local haematoma is less frequent in the 50 IU/kg group, with no statistical difference. CONCLUSIONS: A weight-adjusted heparin dose allows for lower ACT levels and decreases in radial compression time without increase in radial artery occlusion. The impact on bleeding complication needs further evaluation in larger series.
RCT Entities:
AIMS: To evaluate the feasibility and safety of an anticoagulation adapted regimen for transradial coronary angiography. METHODS AND RESULTS: We randomly assigned 162 consecutive patients who benefited from an elective transradial approach for coronarography to receive either a standard dose of 5,000 IU heparin or 50 IU/kg with an upper limit of 5,000 IU. Patients under anti-vitamin K therapy were excluded. The TRband compression system was employed for the entire population after the procedure. Radial artery patency, the primary endpoint, was evaluated with Doppler before discharge from the hospital. Secondary endpoints were: ACT level immediately before sheath removal, compression length and bleeding complications. Both groups were well matched. ACT level is significantly lower in the adjusted anticoagulation group (231.4 min, vs. 265.6 min, p<10-4). Radial compression time was higher in the standard protocol group (235.5 min, vs. 204.5 min, p<10-5). No radial occlusion was noted, whatever the group considered. Local haematoma is less frequent in the 50 IU/kg group, with no statistical difference. CONCLUSIONS: A weight-adjusted heparin dose allows for lower ACT levels and decreases in radial compression time without increase in radial artery occlusion. The impact on bleeding complication needs further evaluation in larger series.
Authors: Abdullah Tuncez; Zeynettin Kaya; Dursun Aras; Abdulkadir Yıldız; Enes Elvin Gül; Mehmet Tekinalp; Mehmet Fatih Karakaş; Halil Lütfü Kısacık Journal: Int J Med Sci Date: 2013-10-03 Impact factor: 3.738
Authors: Muhammad Rashid; Chun Shing Kwok; Samir Pancholy; Sanjay Chugh; Sasko A Kedev; Ivo Bernat; Karim Ratib; Adrian Large; Doug Fraser; James Nolan; Mamas A Mamas Journal: J Am Heart Assoc Date: 2016-01-25 Impact factor: 5.501