Effectiveness of Manual Pressure Hemostasis Following Transfemoral Coronary Angiography in Patients on Therapeutic Warfarin Anticoagulation

El‐Jack, Seif; Ruygrok, Peter; Webster, Mark; Stewart, James T.; Bass, N. M.; Armstrong, Guy; Ormiston, John A.; Pornratanarangsi, Suwatchai

doi:10.1016/j.amjcard.2005.09.079

Cited by 35 publications

(17 citation statements)

References 7 publications

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“…In the only small randomized study therapeutic OAC and warfarin withdrawal (≥48 h) resulted in similar outcome in patients undergoing coronary angiography, but it took a median of 9 days for INR to return to the therapeutic level. 15 In the earlier non-randomized studies, this simple UAC strategy was at least as safe as that of more complicated interrupted OAC, but the low methodological quality of studies precludes any definitive conclusions. 6 Current guidelines include limited guidance on long-term OAC during the peri-PCI period and some have even ignored 18 In the European Society of Cardiology (ESC) guidelines for the management of valvular heart disease, continuation of OAC at modified doses is recommended for the majority of patients who undergo cardiac catheterization.…”

Section: Discussionmentioning

confidence: 99%

Heparin Bridging vs. Uninterrupted Oral Anticoagulation in Patients With Atrial Fibrillation Undergoing Coronary Artery Stenting

Lahtela

Rubboli

Schlitt

et al. 2012

Circ J

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp t is estimated that approximately 5% of patients referred for percutaneous coronary intervention (PCI) have an indication for long-term oral anticoagulation (OAC), mainly because of atrial fibrillation (AF). 1-4 Current guidelines recommend bridging therapy (BT) with unfractionated heparin or low-molecular-weight heparin (LMWH) to cover the temporary discontinuation of OAC, if the risk of thromboembolism is considered high. 5 Neither randomized trials nor large prospective datasets, however, have compared different strategies to manage long-term OAC during PCI. Data from recent observational studies suggest that uninterrupted OAC (UAC) could replace heparin bridging in OAC patients undergoing PCI with favorable balance between bleeding and thrombotic complications. Performing PCI during therapeutic anticoagulation (international normalized ratio [INR] 2.0-3.0) is currently regarded as an alternative strategy. 6,7 Given these prerequisites, we decided to test the hypothesis that UAC would not increase periprocedural bleeding and thrombotic compli-I

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Section: Discussionmentioning

confidence: 99%

Heparin Bridging vs. Uninterrupted Oral Anticoagulation in Patients With Atrial Fibrillation Undergoing Coronary Artery Stenting

Lahtela

Rubboli

Schlitt

et al. 2012

Circ J

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“…Manual compression is time consuming and requires prolonged immobility. Longer duration of compression is directly correlated to decreased complications 106. Arterial access closure devices are now widely used and available, and include mechanical seals and collagen plugs 107 108.…”

Section: Recommendationsmentioning

confidence: 99%

Post-thrombectomy management of the ELVO patient: Guidelines from the Society of NeuroInterventional Surgery

Leslie‐Mazwi

Chen

et al. 2017

J NeuroIntervent Surg

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“…Femoral access complications remain infrequent, ranging from <1% to 17% of procedures 3–7. It is not uncommon to see patients presenting to the cardiac catheterization laboratory on oral anticoagulant (OAC) fully or partially anticoagulated and undergoing common femoral artery (CFA) access 8. Several new OAC (NOACs; oral Xa and thrombin inhibitors) have emerged within the past 3–6 years and are now an alternative to warfarin in treating patients with nonvalvular atrial fibrillation or venous thromboembolic disease 9.…”

Section: Introductionmentioning

confidence: 99%

Predictors of common femoral artery access site complications in patients on oral anticoagulants and undergoing a coronary procedure

Shammas

Jones-Miller

et al. 2017

TCRM

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BackgroundIt is unclear whether patients on oral anticoagulants (OAC) undergoing a procedure using common femoral artery access have higher adverse events when compared to patients who are not anticoagulated at the time of the procedure.MethodsWe retrospectively reviewed data from consecutive patients who underwent a cardiac procedure at a tertiary medical center. Patients were considered (group A) fully or partially anticoagulated if they had an international normalized ratio (INR) ≥1.6 on the day of the procedure or were on warfarin or new OAC within 48 h and 24 h of the procedure, respectively. The nonanticoagulated group (group B) had an INR <1.6 or had stopped their warfarin and new OAC >48 h and >24 h preprocedure, respectively. The index primary end point of the study was defined as the composite end point of major bleeding, vascular complications, or cardiovascular-related death during index hospitalization. The 30-day primary end point was defined as the occurrence of the index primary end point and up to 30 days postprocedure.ResultsA total of 779 patients were included in this study. Of these patients, 27 (3.5%) patients were in group A. The index primary end point was met in 11/779 (1.4%) patients. The 30-day primary composite end point was met in 18/779 (2.3%) patients. There was no difference in the primary end point at index between group A (1/27 [3.7%]) and group B (10/752 [1.3%]; P=0.3155) and no difference in the 30-day primary composite end point between group A (2/27 [7.4%]) and group B (16/752 [2.1%]; P=0.1313). Multivariable analysis showed that a low creatinine clearance (odds ratio [OR] =0.56; P=0.0200) and underweight patients (<60 kg; OR =3.94; P=0.0300) were independent predictors of the 30-day primary composite end point but not oral anticoagulation (P=0.1500).ConclusionPatients on OAC did not have higher 30-day major adverse events than those who were not anticoagulated at index procedure.

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Effectiveness of Manual Pressure Hemostasis Following Transfemoral Coronary Angiography in Patients on Therapeutic Warfarin Anticoagulation

Cited by 35 publications

References 7 publications

Heparin Bridging vs. Uninterrupted Oral Anticoagulation in Patients With Atrial Fibrillation Undergoing Coronary Artery Stenting

Heparin Bridging vs. Uninterrupted Oral Anticoagulation in Patients With Atrial Fibrillation Undergoing Coronary Artery Stenting

Post-thrombectomy management of the ELVO patient: Guidelines from the Society of NeuroInterventional Surgery

Predictors of common femoral artery access site complications in patients on oral anticoagulants and undergoing a coronary procedure

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