Current Trends in Heparin Use During Arterial Vascular Interventional Radiology
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This study was designed to assess the current use of heparinized saline and bolus doses of heparin in non-neurological interventional radiology and to determine whether consensus could be reached to produce guidance for heparin use during arterial vascular intervention.
An interactive electronic questionnaire was distributed to members of the British Society of Interventional Radiology regarding their current practice in the use, dosage, and timing of heparin boluses and heparinized flushing solutions.
A total of 108 completed questionnaires were received. More than 80% of respondents used heparinized saline with varying concentrations; the most prevalent was 1,000 IU/l (international units of heparin per liter) and 5,000 IU/l. Fifty-one percent of interventionalists use 3,000 IU as their standard bolus dose; however, the respondents were split regarding the timing of bolus dose with ~60% administering it after arterial access is obtained and 40% after crossing the lesion. There was no consensus on altering dose according to body weight, and only 4% monitored clotting parameters.
There seems to be some coherence among practicing interventionalists regarding heparin administration. We hypothesize that heparinized saline should be used at a recognized standard concentration of 1,000 IU/l as a flushing concentration in all arterial vascular interventions and that 3,000 IU bolus is considered the standard dose for straightforward therapeutic procedures and 5000 IU for complex, crural, and endovascular aneurysm repair work. The bolus should be given after arterial access is obtained to allow time for optimal anticoagulation to be achieved by the time of active intervention and stenting. Further research into clotting abnormalities following such interventional procedures would be an interesting quantifiable follow-up to this initial survey of opinions and practice.
KeywordsHeparin Arterial Vascular intervention
Conflict of interest
- 3.Wallace S, Medellin H, De Jongh D, Gianturco C (1972) Systematic heparinization for angiography. Am J Roentgenol Rad Ther Nucl Med 116(1):204–209Google Scholar
- 4.Moss JG, Uberoi R, Kinsman R, Walton P (2008) Third British Society of Interventional Radiologists Iliac angioplasty and stenting report (BIAS III) audit and registries, published by Dendrite Clinical SystemsGoogle Scholar
- 13.Altenburg A, Haage P (2011) Antiplatelet and anticoagulant drugs in interventional radiology. Cardiovasc Intervent Radiol 23:1–7Google Scholar
- 14.Jacobsson B, Bergentz SE, Ljungquist U (1969) Platelet adhesion and thrombus formation on vascular catheters in dogs. Acta Radiol Diag 8:97Google Scholar
- 15.Antonovic R, Rosch J, Dotter CT (1976) The value of systemic arterial heparinisation in transfemoral angiography: a prospective study. Am J Radiol 127:223–225Google Scholar
- 16.British National Formulary 58. BMJ Group. September 2009Google Scholar
- 17.Despotis GJ, Summerfield AL, Joist JH, Goodnough LT, Santoro SA, Spitznagel E, Cox JL, Lappas G (1994) Comparison of activated coagulation time and whole blood heparin measurements with laboratory plasma anti-Xa heparin concentration in patients having cardia operations. J Thorac Cardiovasc Surg 108:1076–1082PubMedGoogle Scholar
- 19.Beguin S, Lindhout T, Hemker HC (1988) The mode of action of heparin in plasma. J Thromb Hemost 60:457–462Google Scholar