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Immediate protamine administration and sheath removal following percutaneous coronary intervention: A prospective study of 429 patients
Author(s) -
Ducas John,
Chan Michael C.Y.,
Miller Anthony,
Kashour Tarek
Publication year - 2002
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.10195
Subject(s) - medicine , conventional pci , percutaneous coronary intervention , groin , hemostasis , surgery , pseudoaneurysm , restenosis , creatine kinase , cardiology , stent , myocardial infarction , complication
We tested the approach of reversing anticoagulation following PCI and immediate sheath removal in 429 consecutive patients. On completion of the PCI, protamine was administered, and the vascular sheath was immediately removed. Stents were used in 364 patients (85%) and GP IIb/IIIa inhibitors were used in 52 patients (12%). Time to achieve hemostasis was 30 ± 17 min. Minor groin bleeding occurred in six patients. One patient required repair of femoral pseudoaneurysm. Mean creatine kinase at 8 and 16 hr post‐PCI were 129 ± 35 and 145 ± 32 units, respectively. Creatine kinase rose to > 3 times normal in 12 out of 350 patients (3.4%). Prior to 48 hr, eight patients (1.9%) required emergency PCI or coronary bypass surgery. Follow‐up at 30 days observed no deaths and only three target vessel revascularizations (0.7%). In conclusion, immediate reversal of anticoagulation and sheath removal after PCI is safe and feasible. Cathet Cardiovasc Intervent 2002;56:196–199. © 2002 Wiley‐Liss, Inc.