title: Heparin administration and monitoring for neuroangiography.
abstract: 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.
authors.affiliation: Department of Neurosurgery, Niigata University, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Fujii
authors.forename: S
authors.initials: S
authors.lastname: Takeuchi
authors.forename: T
authors.initials: T
authors.lastname: Koike
authors.forename: K
authors.initials: K
authors.lastname: Nishimaki
authors.forename: Y
authors.initials: Y
authors.lastname: Ito
authors.forename: R
authors.initials: R
authors.lastname: Tanaka
authors.forename: K
authors.initials: K
authors.lastname: Okamoto
mesh_terms: 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
chemical_list: D011479:Protamines; D006493:Heparin