Multicenter Randomized Evaluation of High Versus Standard Heparin Dose on Incident Radial Arterial Occlusion After Transradial Coronary Angiography

Hahalis, George; Leopoulou, Marianna; Xanthopoulou, Ioanna; Patsilinakos, Sotirios; Patsourakos, Nikolaos G.; Ziakas, Antonios; Kafkas, Nikolaos; Koutouzis, Michalis; Tsiafoutis, Ioannis; Athanasiadis, Ilias; Koniari, Ioanna; Almpanis, George; Anastasopoulou, Maria; Despotopoulos, Stefanos; Kounis, Nikos; Dapergola, Athina; Aznaouridis, Konstantinos; Davlouros, Periklis

doi:10.1016/j.jcin.2018.08.009

Cited by 66 publications

(53 citation statements)

References 26 publications

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“…This document recommended administering unfractionated heparin (5,000 unit bolus or 50u/kg) through intravenous or intra‐arterial methods. Recent clinical trial evidence demonstrated that higher doses of heparin may further improve radial patency rates, although its safety and added efficacy while adhering to all best practices need to be further evaluated . At least 5,000 U bolus (or 50 U/kg bolus in patients at extremes of weight spectrum) should be administered following sheath insertion.…”

Section: Prevention Of Radial Artery Occlusion: Overview Of Current Pmentioning

confidence: 99%

SCAI expert consensus statement update on best practices for transradial angiography and intervention

Shroff

Gulati

Drachman

et al. 2019

Cathet Cardio Intervent

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Transradial angiography and intervention continues to become increasingly common as an access site for coronary procedures. Since the first "Best Practices" paper in 2013, ongoing trials have shed further light onto the safest and most efficient methods to perform these procedures. Specifically, this document comments on the use of ultrasound to facilitate radial access, the role of ulnar artery access, the utility of non-invasive testing of collateral flow, strategies to prevent radial artery occlusion, radial access for primary PCI and topics that require further study.

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Section: Prevention Of Radial Artery Occlusion: Overview Of Current Pmentioning

confidence: 99%

SCAI expert consensus statement update on best practices for transradial angiography and intervention

Shroff

Gulati

Drachman

et al. 2019

Cathet Cardio Intervent

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“…This was not offset by a higher local haematoma, BARC type 3 bleeding (Bleeding Academic Research Consortium) or transfusions. Furthermore, the median haemostasis time did not differ significantly between both groups (3.5 hours vs 3.7 hours) 9…”

mentioning

confidence: 79%

Performing diagnostic radial access coronary angiography on uninterrupted direct oral anticoagulant therapy: a prospective analysis

Alasnag

2019

Open Heart

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“…A meta-analysis that included 31,345 patients and 66 studies concluded that high dose heparin (5000 IU) administration decreased the risk of RAO by 64%, and reducing compression times decreased this risk by 72% [19]. A recent study of high dose (100 IU/kg body weight) versus 50 IU/kg/body weight) lowered RAO [20]. That is why it has been recommended to administer at 5000 U or 50 or higher IU/kg body weight unfractionated heparin for all procedures with radial artery access [18,21].…”

Section: Rao: Prevention/therapymentioning

confidence: 99%

Radial Artery Access

Panetta¹,

Chahine²

2021

Interventional Treatment for Structural Heart Disease

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Radial artery access for angiography has matured over the past two decades and is now the preferred point of access for most patients. Lower bleeding rates in clinical randomized trials have translated into lower mortality prompting change in the guidelines. Advances in technique with use of ultrasound for access to properly size the sheath, proper dosing of anticoagulation and new techniques for sheath removal have dramatically lowered radial artery occlusion rates. Radial artery spasm has improved with vasodilators and proper sedation. Advances in support boards and sheath extension have opened up left radial access. Advances in lower profile sheaths and sheathless systems allow larger catheters in smaller arteries. Advances in longer balloons and sheaths have opened up radial access for peripheral interventions. Areas of clinical research include use of ulnar artery compared to radial, left versus right radial access, use of radial artery for a surgical conduit after angiography, radiation exposure and advantage of radial approach in the elderly.

show abstract

Multicenter Randomized Evaluation of High Versus Standard Heparin Dose on Incident Radial Arterial Occlusion After Transradial Coronary Angiography

Cited by 66 publications

References 26 publications

SCAI expert consensus statement update on best practices for transradial angiography and intervention

SCAI expert consensus statement update on best practices for transradial angiography and intervention

Performing diagnostic radial access coronary angiography on uninterrupted direct oral anticoagulant therapy: a prospective analysis

Radial Artery Access

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