Early Removal of the Arterial Sheath After Percutaneous Coronary Intervention Using the Femoral Approach: Safety and Efficacy Study

Zago, Gabriel; Trentin, Fabio; F, Guy; Prado, Alfredo Hirschson; Spadaro, André Gasparini; Silva, Expedito Eustáquio Ribeiro da; Campos, Carlos M.; Perin, Marco Antônio; Falcão, Breno de Alencar Araripe; Esteves-Filho, Antonio; Kajita, Luiz J.; Gama, Mônica Elinor Alves; Marchiori, Gilberto Guilherme Ajjar; Horta, Pedro; Takimura, Celso Kiyochi; Mariani, José; Galon, Micheli Zanotti; Soares, Paulo Rogério; Zalc, Silvio; Kalil‐Filho, Roberto; Neto, Pedro Alves Lemos

doi:10.1016/s2214-1235(15)30009-0

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…After the procedure, manual compression can be safely performed once the anticoagulant effect of heparin has dissipated (activated clotting time [ACT] < 150–180 s) 42, 43 44 .…”

Section: Consensus Recommendations From Access Radial™ Advisory Boardmentioning

confidence: 99%

Transradial access for coronary diagnostic and interventional procedures: Consensus statement and recommendations for India

Goel

Menon

Mullasari

et al. 2018

Indian Heart Journal

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Radial access for cardiac catheterization and intervention in India has been growing steadily over the last decade with favorable clinical outcomes. However, its usage by interventional cardiologists varies greatly among Indian operators and hospitals due to large geographic disparities in health care delivery systems and practice patterns. It also remains unclear whether the advantages, as well as limitations of transradial (TR) intervention (as reported in the western literature), are applicable to developing countries like India or not. An evidence-based review involving various facets of radial procedure for cardiac catheterization, including practical, patient-related and technical issues was conducted by an expert committee that formed a part of Advancing Complex CoronariES Sciences through TransRADIAL intervention (ACCESS RADIAL™) Advisory Board. Emerging challenges in redefining TR management based on evidence supporting practices were discussed to formulate these final recommendations through consensus.

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“…After the procedure, manual compression can be safely performed once the anticoagulant effect of heparin has dissipated (activated clotting time [ACT] < 150–180 s) 42, 43 44 .…”

Section: Consensus Recommendations From Access Radial™ Advisory Boardmentioning

confidence: 99%

Transradial access for coronary diagnostic and interventional procedures: Consensus statement and recommendations for India

Goel

Menon

Mullasari

et al. 2018

Indian Heart Journal

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“…Patients with successful complex PCI remain at increased risk of bleeding and stent thrombosis due to incomplete stent expansion, bifurcation stenting, and use of multiple long stents. Several studies have shown that immediate anticoagulant reversal with protamine and sheath removal is a safe alternative to standard manual compression after PCI [ 5 – 7 ]. As complex PCI itself has a higher thrombotic risk than simple PCI, the use of protamine is expected to increase the risk of stent thrombosis.…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of immediate heparin reversal with protamine after complex percutaneous coronary intervention

Choi

Chun

Jung

et al. 2022

BMC Cardiovasc Disord

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Background Compared to simple percutaneous coronary intervention (PCI), complex PCI is associated with higher bleeding and thrombotic risk. No previous study has evaluated the use of protamine after PCI with contemporary technologies. This study aimed to evaluate the safety and efficacy of manual compression with and without protamine after transfemoral complex PCI. Methods We retrospectively analyzed 160 patients (protamine group, n = 92; non-protamine group, n = 68) who underwent complex PCI via the femoral artery. The primary outcome was a composite of in-hospital death, myocardial infarction, stent thrombosis, stroke/systemic embolism, bleeding requiring blood transfusion, and vascular access complications. Results The primary outcome was significantly lower in the protamine group than in the non-protamine group (4.3% vs. 17.6%; p = 0.006). This was driven mainly by the lower incidences of hematoma in the protamine group (3.3% vs. 13.2%, p = 0.020). Furthermore, the protamine group had a significantly shorter hospital stay than the non-protamine group (4.8 ± 3.7 days vs. 8.4 ± 8.3 days, p = 0.001). While > 90% of the patients had acute coronary syndrome, there were no incidences of myocardial infarction or stent thrombosis in either group. Conclusions Among patients who underwent complex PCI via transfemoral access, immediate protamine administration was associated with a significantly lower rate of vascular access complications, especially hematoma, and shorter hospital stay than no protamine administration.

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Early Removal of the Arterial Sheath After Percutaneous Coronary Intervention Using the Femoral Approach: Safety and Efficacy Study

Cited by 2 publications

References 12 publications

Transradial access for coronary diagnostic and interventional procedures: Consensus statement and recommendations for India

Transradial access for coronary diagnostic and interventional procedures: Consensus statement and recommendations for India

Safety and efficacy of immediate heparin reversal with protamine after complex percutaneous coronary intervention

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