The pharmacokinetics and UK usage of heparin in vascular intervention

The Use of Heparin during Endovascular Peripheral Arterial Interventions: A Synopsis

“…Heparin is also used during PAI as a flushing solution on the sideport of a sheath, mostly diluted with saline (hepsal), and to coat catheters and wires. This current widespread use of heparin is in accordance with earlier reports from Europe and the United States [ 3 – 5 ].…”

“…But despite these guidelines and the worldwide use of heparin for the past 30-plus years, there still is no consensus on many aspects of its use in PAI. Mentioned surveys in the UK and Netherlands [ 1 , 2 , 5 ] showed a significant variation in all aspects of heparin use during PAI. Alarmingly, the described variation in Netherlands and the UK was not only present in both countries, but also different between those countries.…”

A Retrospective Study on the Use of Heparin for Peripheral Vascular Intervention

“…6 In a study published by Zaman et al in 1996, the authors recommended that a bolus dose of 3000 units of heparin be given when the lesion to be treated had been successfully crossed, larger doses being reserved for longer or more complex procedures. 7…”

“…6 In a study published by Zaman et al in 1996, the authors recommended that a bolus dose of 3000 units of heparin be given when the lesion to be treated had been successfully crossed, larger doses being reserved for longer or more complex procedures. 7 The lack of universal agreement on the use of heparin during endovascular procedures has also been highlighted in a recent survey of members of the Vascular Society of Great Britain and Ireland. 8 This survey focused on abdominal aortic aneurysms and reported that 87% of respondents who performed elective endovascular repair of abdominal aortic aneurysms administer heparin during the procedure.…”

Neurological Outcomes after Carotid Stenting Protected with the NeuroShield Filter Compared to Unprotected Stenting

“…The activated coagulation time (ACT) was not routinely measured, assuming that this heparin dose would maintain the ACT within therapeutic range (at least twice normal) for Ն45 minutes in the majority. 15 Additional heparin (1000 to 2000 units) was administered for procedures lasting Ͼ45 minutes.…”