Low-molecular-weight heparin (reviparin) reduces the incidence of femoropopliteal in-stent stenosis: preliminary results of an ongoing study.
OBJECTIVE
To examine the efficacy of the low-molecular-weight heparin, reviparin, for prevention of femoropopliteal stent restenosis.


METHODS
Forty-two patients who had implantation of flexible tantalum stents for the treatment of stenosis (n = 24) or occlusion (n = 18) of the femoral (n = 27) or popliteal (n = 15) arteries were included in this study protocol. An intraarterial bolus of 5000 IU heparin was given before percutaneous transluminal angioplasty (PTA), and in the case of stent implantation due to unsuccessful PTA, an additional dose of reviparin (3500 anti-factor Xa IU) was given. Postprocedurally, 10,500 anti-factor Xa IU of reviparin were administered intravenously over 24 hr, followed by 3500 anti-factor Xa IU subcutaneously twice a day for 23 days. Oral aspirin (100 mg/day) was prescribed for the long term. Follow-up criteria (maximum follow-up 37 months) were clinical symptoms, Doppler ankle arm indices, color and duplex sonography, and angiography for suspicion of restenosis.


RESULTS
Early stent thromboses were not observed. Overall primary patency rate (PPR) was 88% +/- 6.0% (1 year) and 74% +/- 10.1% (2 years). Major hemorrhagic complications have not occurred.


CONCLUSIONS
Reviparin administered in a high dose over a period of 24 days is a safe medication regimen and provides excellent patency rates after stent implantation.
Strecker
E P
EP
Department of Radiology, Diakonissen Hospital, Karlsruhe, Germany.
Göttmann
D
D
Boos
I B
IB
Vetter
S
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000009:adverse effects; D000925:Anticoagulants / Q000008:administration & dosage*; D001157:Arterial Occlusive Diseases / Q000188:drug therapy* / Q000601:surgery*; D003251:Constriction, Pathologic / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005268:Femoral Vein / Q000601:surgery*; D005500:Follow-Up Studies; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011152:Popliteal Vein / Q000601:surgery*; D011184:Postoperative Period; D011292:Premedication; D011300:Preoperative Care; D011446:Prospective Studies; D055502:Secondary Prevention; D015607:Stents / Q000009:adverse effects*; D016896:Treatment Outcome; D014654:Vascular Patency / Q000187:drug effects*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; C094240:reviparin