Frequency of Radial Artery Occlusion After Transradial Access in Patients Receiving Warfarin Therapy and Undergoing Coronary Angiography
| Autor: | Imdad Ahmed, Samir Pancholy, Olivier F. Bertrand, Tejas Patel |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Male
Cardiac Catheterization medicine.medical_specialty Arterial Occlusive Diseases Coronary Disease Coronary Angiography Asymptomatic Risk Factors Internal medicine medicine.artery Occlusion medicine Humans Radial artery Aged Retrospective Studies business.industry Incidence Warfarin Anticoagulants Heparin Pennsylvania Prognosis Surgery Hemostasis Radial Artery Cardiology Introducer sheath Female medicine.symptom Bolus (digestion) Cardiology and Cardiovascular Medicine business Follow-Up Studies medicine.drug |
| Zdroj: | The American Journal of Cardiology. 113:211-214 |
| ISSN: | 0002-9149 |
| Popis: | The efficacy of warfarin-induced anticoagulation in reducing radial artery occlusion (RAO) after transradial access is not known. The present case-control study compared the incidence of early (24 hours) and late (30 days) RAO in patients undergoing transradial diagnostic coronary angiography during therapeutic warfarin anticoagulation (group 1) with that of a matched (3:1) cohort of patients not receiving warfarin and receiving intraprocedural heparin (group 2). All patients underwent transradial diagnostic coronary angiography using a 5F hydrophilic introducer sheath. The patients in group 2 received an intravenous heparin bolus (50 IU/kg) immediately after sheath insertion. After sheath removal, hemostasis was obtained using the TR-band (Terumo Interventional Systems, Terumo Medical, Tokyo, Japan) and a plethysmography-guided patent hemostasis technique. We included 86 patients receiving warfarin with an international normalized ratio of 2 to 4 in group 1 and 250 matched patients in group 2. No significant differences were present in the demographic and procedural variables between the 2 groups. Early RAO occurred in 18.6% of the patients in group 1 compared with 9.6% of patients in group 2 (p = 0.024). The incidence of late RAO remained significantly higher in group 1 compared with group 2 (13.9% vs 5.2%, p = 0.01). All patients with RAO remained asymptomatic. In conclusion, patients receiving chronic oral anticoagulation with warfarin and undergoing transradial coronary angiography without parenteral anticoagulation had a higher incidence of early and late RAO compared with patients receiving standard intravenous heparin therapy. |
| Databáze: | OpenAIRE |
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