TY - JOUR
T1 - Systemic Heparinization During Percutaneous Coronary Angiography
T2 - Evaluation of Effectiveness in Decreasing Thrombotic and Embolic Catheter Complications
AU - Luepker, Russell V.
AU - Bouchard, Richard J.
AU - Burns, Roberta
AU - Warbasse, J. Richard
PY - 1975
Y1 - 1975
N2 - Systemic heparinization has been advocated as preventive for thrombotic and embolic complications of arterial catheterization. To test this hypothesis, 95 patients undergoing coronary angiography via the percutaneous femoral arterial approach were randomized into heparinized and nonheparinized groups. Evaluation for thrombotic and embolic complications by clinical means and noninvasive electrical impedance flow measurements in the lower limbs was performed precatheterization, postcatheterization, and at 4 and 24 hr. Clinical data reveal loss of distal leg pulses in 11% (5/47) of the nonheparinized group, with two of these individuals developing signs of claudication and requiring embolectomy. No individuals (0/48) in the heparinized group lost distal leg pulses. Immediate, 4‐hr, and 24‐hr postcatheterization bloodflow was 12%, 10%, and 12% lower, respectively, in the catheterized limb of those in the nonheparinized group. At 24 hr 52% of the nonheparinized group had bloodflow levels lower than the precatheterization levels in the right (catheterized) extremity, while 2% (2/48) of the heparinized group had a similar reduction. One possible complication of excess bleeding was noted with heparin. It is concluded that systemic heparinization is safe and can be an important adjunct in the reduction of thromboembolic complications of percutaneous coronary angiography.
AB - Systemic heparinization has been advocated as preventive for thrombotic and embolic complications of arterial catheterization. To test this hypothesis, 95 patients undergoing coronary angiography via the percutaneous femoral arterial approach were randomized into heparinized and nonheparinized groups. Evaluation for thrombotic and embolic complications by clinical means and noninvasive electrical impedance flow measurements in the lower limbs was performed precatheterization, postcatheterization, and at 4 and 24 hr. Clinical data reveal loss of distal leg pulses in 11% (5/47) of the nonheparinized group, with two of these individuals developing signs of claudication and requiring embolectomy. No individuals (0/48) in the heparinized group lost distal leg pulses. Immediate, 4‐hr, and 24‐hr postcatheterization bloodflow was 12%, 10%, and 12% lower, respectively, in the catheterized limb of those in the nonheparinized group. At 24 hr 52% of the nonheparinized group had bloodflow levels lower than the precatheterization levels in the right (catheterized) extremity, while 2% (2/48) of the heparinized group had a similar reduction. One possible complication of excess bleeding was noted with heparin. It is concluded that systemic heparinization is safe and can be an important adjunct in the reduction of thromboembolic complications of percutaneous coronary angiography.
KW - catheter complications
KW - coronary angiography
KW - systemic heparinization
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U2 - 10.1002/ccd.1810010107
DO - 10.1002/ccd.1810010107
M3 - Article
C2 - 1222406
AN - SCOPUS:0016809663
VL - 1
SP - 35
EP - 45
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
SN - 1522-1946
IS - 1
ER -