Direct thrombin inhibitors and vascular closure devices: Same answers, same questions

摘要

The retrospective analysis by Theodos et al. in this issue of CCI evaluates the associations between vascular complications and bivalirudin versus glycoprotein (GP) Ilb/IIIa inhibitors as well as vascular closure device (VCD) use versus manual compression (MC). This is familiar ground, with a number of prior retrospective looks. A study by Sanborn et al. [1] based on the ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy) Trial had many similar features but was derived from a prospective randomization to bivalirudin versus heparin plus GP lib/ Ilia inhibitors. Both the post hoc ACUITY analysis and the current study offer the same conclusions regarding vascular complications of PCI: bivalirudin is superior to GP ilb/HIa inhibitors and VCDs are superior to MC.