Safety of transradial diagnostic cardiac catheterization in patients under oral anticoagulant therapy

Gallego-Sánchez, Gonzalo; Gallardo‐López, Arsenio; Córdoba-Soriano, Juan G.; Gutiérrez-Díez, Antonio; Melehi, Driss; Barrionuevo-Sánchez, María Isabel; Jiménez-Mazuecos, Jesús

doi:10.1016/j.jjcc.2016.04.015

Cited by 5 publications

(4 citation statements)

References 30 publications

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“…22 In our study 12.7% cases of group A developed haematoma as compared to 22.2% of group B (p=0.15) Although we did not rule out prior use of anticoagulation, but a study found no difference in rate of haematoma formation in patients with history of anticoagulation 5% as compared to 4.6% in patients without prior use who underwent radial artery catheterization. 23 Radial artery haematoma was reported in only 2.3% cases who underwent radial artery catheterization, although the study was questionnaire based. 24 Mean time required for group A patients was 71.0 ± 26.4 minutes while of group B was 96.5 ± 62.3 minutes, which was statistically significant, p= 0.31.…”

Section: Groupmentioning

confidence: 97%

Comparison between ultrasound guided and palpatory method for radial artery Catheterization.

Tariq¹,

Afzal²

2022

TPMJ

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Objective: To compare ultrasound guided and palpatory method of radial artery Catheterization in terms of number of attempts, total time required, frequency of catheterization in first attempt and haematoma formation after the procedure. Study Design: Randomized Control Trial. Setting: Intensive Care Units of Jinnah Burn and Reconstructive Surgery Center Lahore and Sharif Medical City Hospital. Period: June to December 2021. Material & Methods: 126 patients were included using nonprobability purposive sampling and divided into group A: ultrasound, B: palpatory group. Number of attempts, total time, successful1st attempt and presence of haematoma was recorded and analyzed to compare outcome. Results: In 85.7% patients of group A, catheterization was done in first attempt while 74.6% in group B. In group A, the mean number of attempts was 1.14 ± 0.35 and 1.29 ± 0.52 in group B (p=0.08). Haematoma rate was 12.7% in group A while 22.2% in B. Mean total time was 71.0 ± 26.4 minutes in group A and 95.5 ± 62.3 in group B. Conclusion: Ultrasound guided radial artery catheterization is better than the palpatory method, particularly in middle aged patients.

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Section: Groupmentioning

confidence: 97%

Comparison between ultrasound guided and palpatory method for radial artery Catheterization.

Tariq¹,

Afzal²

2022

TPMJ

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“…A recent prospective observational study compared acenocoumarol continuation versus discontinuation in 489 patients undergoing trans-radial diagnostic catheterization. The study concluded that continuation of chronic OAT appears safe during trans-radial diagnostic catheterization [ 95 ]. Similarly, in a prospective study, Sanmartín M et al concluded that the trans-radial approach appears to be a safe option and could be the technique of choice for patients continuing long-term acenocoumarol therapy as it eludes the problems and complications associated with the withdrawal of OAT [ 96 ].…”

Section: Anticoagulationmentioning

confidence: 99%

Follow-up and management of valvular heart disease patients with prosthetic valve: a clinical practice guideline for Indian scenario

Saksena

Mishra

Muralidharan

et al. 2019

Indian J Thorac Cardiovasc Surg

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Purpose Valvular heart disease (VHD) patients after prosthetic valve implantation are at risk of thromboembolic events. Followup care of patients with prosthetic valve has a paramount role in reducing the morbidity and mortality. Currently, in India, there is quintessential need to stream line the follow-up care of prosthetic valve patients. This mandates the development of a consensus guideline for the antithrombotic therapy in VHD patients post prosthetic valve implantation. Methods A national level panel was constituted comprising 13 leading cardio care experts in India who thoroughly reviewed the up to date literature, formulated the recommendations, and developed the consensus document. Later on, extensive discussions were held on this draft and the recommendations in 8 regional meetings involving 79 additional experts from the cardio care in India, to arrive at a consensus. The final consensus document is developed relying on the available evidence and/or majority consensus from all the meetings. Results The panel recommended vitamin K antagonist (VKA) therapy with individualized target international normalized ratio (INR) in VHD patients after prosthetic valve implantation. The panel opined that management of prosthetic valve complications should be personalized on the basis of type of complications. In addition, the panel recommends to distinguish individuals with various co-morbidities and attend them appropriately. Conclusions Anticoagulant therapy with VKA seems to be an effective option post prosthetic valve implantation in VHD patients. However, the role for non-VKA oral therapy in prosthetic valve patients and the safety and efficacy of novel oral anticoagulants in patients with bioprosthetic valve need to be studied extensively.

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“…A recent paper by Gallego-Sanchez et al evaluated the safety of transradial catheterization in patients on anticoagulation and concluded that while patients on anticoagulation were generally older, no complications or statistically significant difference in hematoma formation was seen in the first 24 hr suggesting that this may be a safe and effective way to perform cardiac catheterization in patients on anticoagulation. 2 Most recently, based on the WOEST trial (and PIONEER AF-PCI and REDUAL-PCI trials for direct oral anticoagulants), it is gaining favor to drop aspirin for double therapy rather than triple therapy. Bleeding episodes were seen in 54 (19%) patients receiving double therapy and in 126 (44%) receiving triple therapy (hazard ratio [HR] 0.36, 95% CI 0.26-0.50, P < 0.0001).…”

Section: The Median International Normalized Ratio (Inr) Was 21 and mentioning

confidence: 99%

“…There are several papers, which suggest that bleeding rates are lower with radial access, particularly in patients who are older, female, and have more comorbid conditions, so it may be reasonable to consider access site in cases where full anticoagulation is present. A recent paper by Gallego‐Sanchez et al evaluated the safety of transradial catheterization in patients on anticoagulation and concluded that while patients on anticoagulation were generally older, no complications or statistically significant difference in hematoma formation was seen in the first 24 hr suggesting that this may be a safe and effective way to perform cardiac catheterization in patients on anticoagulation …”

mentioning

confidence: 99%

STEMIs and Coumadin: Are they an unsafe combination?

Montgomery

Levy²

2019

Cathet Cardio Intervent

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Safety of transradial diagnostic cardiac catheterization in patients under oral anticoagulant therapy

Abstract: Performing a transradial diagnostic cardiac catheterization without removal of the oral chronic anticoagulation appears safe in patients under acenocumarol therapy.

Cited by 5 publications

References 30 publications

Comparison between ultrasound guided and palpatory method for radial artery Catheterization.

Comparison between ultrasound guided and palpatory method for radial artery Catheterization.

Follow-up and management of valvular heart disease patients with prosthetic valve: a clinical practice guideline for Indian scenario

STEMIs and Coumadin: Are they an unsafe combination?

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