A retrospective study on the use of heparin for peripheral vascular intervention

摘要

Purpose. To compare immediate outcomes for patients who receive and those who do not receive heparin during lower limb endovascular intervention. Methods. A retrospective case series of 330 procedures for lower limb peripheral arterial occlusive disease. Patient records were interrogated for bleeding or thrombotic/embolic complications during or immediately after endovascular intervention for peripheral arterial occlusive disease. Results. Of the 220 patients who received heparin, 21 (9.6%) suffered an access site bleed compared with 2 of the 110 patients (2%) who did not receive heparin (odds ratio [OR] = 5.7; 95% confidence interval [CI] = 1.3-25; P =.01). There were 6 embolic/thrombotic complications in the patients who received heparin (2.7%) compared with 4 in those that did not receive heparin (3.6%; P =.74). In 187 cases, a closure or compression device was used (StarClose, n = 109; Angio-Seal, n = 42; FemoStop, n = 35; ProGlide, n = 1), of which there were 3 access bleeding complications (2%). One hundred and forty-three cases did not have a closure or compression device associated with 17 (12%) access bleeding complications (OR = 0.25; 95% CI = 0.09-0.64; P =.004). Conclusions. In this study, heparin use and nonuse of a closure or compression device was associated with an increased risk of access site bleeding. Embolic/thrombotic complications were uncommon.