Heparin versus bivalirudin for carotid artery stenting using proximal endovascular clamping for neuroprotection: results from a prospective randomized study.
J Vasc Surg
; 52(6): 1505-10, 2010 Dec.
Article
em En
| MEDLINE
| ID: mdl-20719465
ABSTRACT
BACKGROUND:
General recommendations indicate that, during a carotid artery stenting (CAS), sufficient unfractionated heparin (UFH) has to be given to maintain the activated clotting time between 250 to 300 seconds. Bivalirudin use is able to reduce postprocedural bleedings in percutaneous interventions when compared with UFH. The study purpose was to evaluate, in a randomized study, the safety and efficacy of bivalirudin versus heparin during CAS, using proximal endovascular occlusion (PEO) as a distal protection device.METHODS:
From January 2006 to December 2009, 220 patients undergoing CAS using PEO have been randomly assigned to one of the study arms (control arm 100 UI/kg UFH or bivalirudin arm 0.75 mg/kg intravenous bolus and intraprocedural infusion at 1.75 mg/kg/h).RESULTS:
Procedural success was achieved in all the patients. No episodes of intraprocedural thrombosis occurred. One major stroke occurred in the bivalirudin arm, and two minor strokes occurred, one in each group. A significant difference in the incidence of postprocedural bleedings was observed between the study groups; bivalirudin use was associated with reduced number of bleedings according to Thrombolysis In Myocardial Infarction criteria.CONCLUSIONS:
The use of bivalirudin should be considered a safe and effective anticoagulation regimen during CAS, using PEO as a distal protection device. Bivalirudin use is associated with a reduced incidence of bleedings.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fragmentos de Peptídeos
/
Heparina
/
Artéria Carótida Interna
/
Stents
/
Estenose das Carótidas
/
Acidente Vascular Cerebral
/
Oclusão com Balão
/
Procedimentos Endovasculares
/
Anticoagulantes
Tipo de estudo:
Clinical_trials
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
J Vasc Surg
Assunto da revista:
ANGIOLOGIA
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
Itália