Document Type
Article
Publication Date
2-2017
Publisher
Wiley
Source Publication
Catheterization and Cardiovascular Interventions
Source ISSN
1522-1946
Original Item ID
DOI: 10.1002/ccd.26684
Abstract
Objectives This study aimed to compare the association of access site complications and the use of unfractionated heparin versus bivalirudin during subinguinal peripheral vascular intervention.
Background Compared to unfractionated heparin, bivalirudin has been associated with fewer bleeding complications in patients undergoing percutaneous coronary intervention but more ischemic events. The safety and efficacy of direct thrombin inhibitors in peripheral vascular interventions is not well defined.
Methods We compared the incidence of in-hospital access site complications and discharge status among patients in the multicenter, prospective Vascular Quality Initiative registry who underwent peripheral vascular intervention between August 2007 and January 2014 using bivalirudin or unfractionated heparin. Propensity score matching was used to obtain a balanced cohort of 1,524 patients in each treatment group.
Results Patients treated with bivalirudin had a significantly lower incidence of access site hematomas (2.4% vs. 3.9%, P = 0.018), shorter post-procedural hospitalization (1.0 vs. 1.2 days, P < 0.001) and lower rates of discharge to a nursing home or rehabilitation center rather than home (7.61% vs. 9.73%, P = 0.034) when compared with unfractionated heparin-treated patients. The incidence of in-hospital access site occlusion, distal embolization, and mortality did not differ significantly between groups.
Conclusions Patients who received bivalirudin had lower rates of access site hematoma, shorter length of stay, and improved discharge status compared with unfractionated heparin during hospitalization for peripheral vascular intervention. Randomized comparisons of these agents are needed to confirm these findings. © 2016 Wiley Periodicals, Inc.
Recommended Citation
Ortiz, Daniel; Singh, Maharaj; Jahangir, Arshad; Allaqaband, Suhail; Khitha, Jayant; Bajwa, Tanvir; and Mewissen, Mark W., "Bivalirudin Versus Unfractionated Heparin During Peripheral Vascular Interventions" (2017). College of Nursing Faculty Research and Publications. 1234.
https://epublications.marquette.edu/nursing_fac/1234
Comments
Accepted version. Catheterization & Cardiovascular Interventions, Vol. 89, No. 3 (February 2017): 408-413. DOI. This article is © 2016 Wiley Periodicals, Inc. Used with permission.
Maharaj Singh was affiliated with Cardiovascular Services, Aurora Sinai/Aurora St. Luke’s Medical Centers, Milwaukee, WI at the time of publication.