title: Post-cardiac catheterization access site complications and low-molecular -weight heparin following cardiac catheterization.
abstract: The low molecular weight heparin enoxaparin is often administered to patients on long-term anticoagulation regimens who temporarily discontinue warfarin prior to undergoing invasive procedures. The clinical outcome of all enoxaparin-treated patients who underwent cardiac catheterization or coronary artery interventional procedures (n = 119) was evaluated. A total of 5 patients (4.2%) requiring anticoagulation (3 with chronic atrial fibrillation and 2 with ventricular thrombi) developed severe late enoxaparin-associated hemorrhagic or vascular complications at the femoral arterial puncture site between 3 and 11 days post-procedure. Complications included development of femoral arterial pseudoaneurysm (n = 3), hypotension (systolic blood pressure < 90 mmHg) (n = 2), acute decrease in hemoglobin levels to < 8.5 mg/dl (n = 4) and cardiac arrest (n = 1). In patients receiving standard dose enoxaparin after percutaneous invasive cardiac procedures, there is the potential for delayed and severe access site hemorrhagic and vascular complications.
authors.affiliation: Division of Cardiology, Department of Meidcine, Northwestern Memorial Hospital Medical School, Chicago, IL 60611, USA. cdavidso@nmh.org
authors.forename: Lee A
authors.initials: LA
authors.lastname: MacDonald
authors.forename: Sheridan
authors.initials: S
authors.lastname: Meyers
authors.forename: Charles L
authors.initials: CL
authors.lastname: Bennett
authors.forename: Dan
authors.initials: D
authors.lastname: Fintel
authors.forename: Neal
authors.initials: N
authors.lastname: Grosshans
authors.forename: Raffy
authors.initials: R
authors.lastname: Syegco
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Davidson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D000925:Anticoagulants / Q000627:therapeutic use*; D006328:Cardiac Catheterization; D003327:Coronary Disease / Q000150:complications / Q000628:therapy; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications / Q000628:therapy; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy* / Q000209:etiology*; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight