In-laboratory femoral sheath removal after heparin reversal by protamine after percutaneous coronary intervention.

OBJECTIVE: To evaluate the safety of heparin neutralisation by protamine immediately after PCI. DESIGN: Retrospective analysis of prospectively registered data. SETTING: A Danish mono-centre study. PATIENTS: All angina pectoris patients treated with PCI between January 1999 and December 2002. The cohort was divided into two groups. Group I (n=1.129 procedures) were patients admitted January 1999 to December 1999, and group II n=4.193 procedures) were admitted January 1, 2000 to December 31, 2002. INTERVENTIONS: In group I, the femoral sheath was removed 4 hours after the PCI procedure. In group II, circulating heparin was neutralised by protamine sulphate, and the femoral sheath removed immediately after the procedure. MAIN OUTCOME MEASURES: Rates of puncture site complications, stent thrombosis, non-fatal myocardial infarction and death during admission. RESULTS: The rates of stent thrombosis, non-fatal myocardial infarction and in-hospital mortality were similar in the two groups. The rate of puncture site complications were 4,7% in group 1 and 2,6% in group 2 (p<0,001). CONCLUSIONS: Circulating heparin can be safely neutralised by protamine sulphate immediately after PCI.