42153
document
Comparison of the effect of intra-arterial versus intravenous heparin on radial artery occlusion after transradial catheterization . Radial artery occlusion ( RAO ) is an infrequent , asymptomatic , complication of transradial catheterization and probably 1 of the few . Intravenous heparin and patent hemostasis lower its incidence . A possible local effect of intra-arterially administered heparin during transradial procedures has not been evaluated . We studied 500 consecutive patients randomized to an intravenous group ( n = 250 ) , receiving 50 U/kg of unfractionated heparin ( maximal dose 5,000 U ) intravenously , and an intra-arterial group ( n = 250 ) receiving the same dose intra-arterially . All patients received a vasodilator " cocktail " intra-arterially and underwent cardiac catheterization using a 5F introducer sheath and catheters . The activated clotting time was measured at the end of the procedure . All patients received hemostasis with a radial compression device ( TR Band ) , applied after sheath removal , for 2 hours . A plethysmographic evaluation for RAO was performed at 24 hours and 30 days after the procedure . Early RAO occurred in 5.6 % ( n = 14 ) of the intravenous group and 6 % ( n = 15 ) of the intra-arterial group . The difference was not statistically significant ( chi-square = 0.037 , p > 0.8 ) . Chronic RAO occurred in 3.2 % , ( n = 8 ) of the intravenous group compared to 4 % ( n = 10 ) of the intra-arterial group . The difference was not statistically significant ( chi-square = 0.231 , p > 0.6 ) . The activated clotting time was 211 +/- 16 seconds in the intravenous group and 213 +/- 17 seconds in the intra-arterial group , a statistically insignificant difference ( t = -1.095 , p > 0.2 ) . In conclusion , intra-arterial and intravenous heparin administration provide comparable efficacy in preventing RAO , favoring a probable systemically mediated mechanism of action , rather than a local effect .
42154
Intervention_Pharmacological
intra-arterial
42155
Intervention_Pharmacological
intravenous heparin
42156
Intervention_Pharmacological
heparin
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Intervention_Physical
intravenous
42158
Intervention_Physical
heparin
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Intervention_Physical
intra-arterial group
42160
Intervention_Physical
intra-arterially
42161
Intervention_Physical
cardiac catheterization
42162
Outcome_Physical
activated clotting time
42163
Outcome_Physical
plethysmographic evaluation for RAO
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Outcome_Other
Early RAO
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Outcome_Mental
Chronic RAO
42166
Outcome_Other
activated clotting time
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Participant_Condition
radial artery occlusion after transradial catheterization .
42168
Participant_Age
500 consecutive patients