Key result
Immediate protamine administration and sheath removal after PCI was safe and feasible, with a mean hemostasis time of 30 minutes, minor groin bleeding in 6 patients, and no deaths at 30 days.
Why the study?
Does immediate protamine administration and sheath removal following PCI provide safe and feasible outcomes in patients undergoing PCI?
Cohort (n=429)
Does immediate protamine administration and sheath removal following PCI provide safe and feasible outcomes in patients undergoing PCI?
Immediate reversal of anticoagulation with protamine and immediate sheath removal after PCI appears safe and feasible with low rates of bleeding and complications.
May support immediate protamine reversal and sheath removal post-PCI; hypothesis-generating and requires randomized confirmation before practice change.
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.
No takes yet. Share an insight, caveat, or question.
Ducas et al. (2002) conducted a cohort in Percutaneous coronary intervention (n=429). Immediate protamine administration and sheath removal was evaluated. Immediate protamine administration and sheath removal after PCI was safe and feasible, with a mean hemostasis time of 30 minutes, minor groin bleeding in 6 patients, and no deaths at 30 days.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: