Heparin administration and monitoring for neuroangiography.
OBJECTIVE
To establish the optimal protocol of heparin administration during interventional neuroradiology.


METHODS
We assessed 100 cases of neuroangiography, including endovascular surgery, and measured activated coagulation time before and 5 minutes after heparin administration, and before and 5 minutes after protamine neutralization. In some cases actual heparin concentration was assayed using a chromogenic substrate technique.


RESULTS
The actual plasma heparin concentration significantly correlated with the dose of heparin administered intravenously (r = .98; P < .0001) and changes in activated coagulation time (r = .85; P < .0001). The change in activated coagulation time significantly correlated with the dose of heparin injected intravenously (r = .54, P < .0001). The ratio of change in activated coagulation time significantly correlated with time elapsed after heparin administration (r = -.70, P < .0001).


CONCLUSIONS
The activated coagulation time is useful in monitoring administration and neutralization of heparin during neuroangiography, and a bolus injection of 60 U/kg heparin should be adequate to carry out neuroangiography for 75 minutes safely, even for endovascular surgery.
Fujii
Y
Y
Department of Neurosurgery, Niigata University, Japan.
Takeuchi
S
S
Koike
T
T
Nishimaki
K
K
Ito
Y
Y
Tanaka
R
R
Okamoto
K
K
D002533:Cerebral Angiography; D016903:Drug Monitoring; D005260:Female; D006493:Heparin / Q000008:administration & dosage* / Q000097:blood; D006801:Humans; D008297:Male; D011479:Protamines / Q000008:administration & dosage; D015641:Radiography, Interventional; D014914:Whole Blood Coagulation Time
D011479:Protamines; D006493:Heparin