Varfarina previne obstruções venosas pós-implante de dispositivos cardíacos em pacientes de alto risco: análise parcial

Abstract

Varfarina previne obstruções venosas pós-implante de dispositivos cardíacos em pacientes de alto risco: análise parcialWarfarin prevents venous obstruction after cardiac devices implantation in high-risk patients: partial analysis Abstract Introduction: The incidence of venous thrombosis after cardiac devices implantation is high. Ventricular dysfunction and previous transvenous temporary leads ipsilaterally to the permanent implantation are independent risk factors. The effect of prophylactic strategies to prevent these complications remains controversial.Objectives: To evaluate the efficacy of prophylactic use of warfarin in patients with high risk of lead-associated thrombosis.Method: Clinical, prospective, randomized and blinded study, in patients submitted to first transvenous leads implantation with LVEF < 0.40 and/or previous ipsilateral temporary pacing. After device implantation, patients were randomly assigned to placebo or warfarin. Periodical clinical and laboratorial evaluations were performed to anticoagulant management. After a six-month period, every patient was submitted to a digital subtraction venography.Results 543SILVA, KR ET AL -Warfarin prevents venous obstruction after cardiac devices implantation in high-risk patients: partial analysis Bras Cir Cardiovasc 2008; 23(4): 542-549 Rev

Use of the transfemoral access approach for cardiac stimulation device implantation when the superior venous approach is not feasible: A single-centre twenty-year series

“…It could be suggested that the difference in vein thrombosis incidence for temporary vs. permanent pacemakers implanted using transfemoral access is due to early mobilization: all patients in our series were mobile on the day after implantation of a permanent pacemaker, and there were no cases of clinical thrombosis in our patients during the 20 years of follow-up. The use of oral anticoagulants in 28 (44%) of our patients also might have helped to reduce the number of thrombotic episodes, as previously reported for upper access implantation 27 .…”

Transjugular Seldinger approach for permanent pacemaker implantation in octogenarian with inaccessible upper limbs venous system

“…The last‐mentioned was likely to be the case, considering the fact that the patient was still very physically active until right before the syncope episodes and no other iatrogenic risk factors were present. A previous report had suggested the safety and benefit of 6‐month warfarin prophylaxis to prevent venous obstruction in high‐risk patients undergoing device implantations . Considering SVC patency, we set our eyes on the right jugular vein as the candidate to insert the ventricular pacemaker lead.…”

Avaliação comparativa da atividade biológica de heparinas não fracionadas pelas metodologias de inibição da coagulação do plasma ovino (ICPO) e de tempo de tromboplastina parcial ativada (TTPA)

“…A heparina, substância natural encontrada abundantemente nas vísceras de suínos e bovinos, é utilizada desde a década de 1930 na terapia anticoagulante, sendo apontada como um dos principais avanços terapêuticos que almejam a redução da mortalidade e incapacidade física, pois sua utilização visa minimizar os efeitos adversos decorrentes das doenças cerebrovasculares (hemorragia, lesões cutâneas e trombocitopenia) e, consequentemente, reduzir sua morbi-mortalidade 1 .…”