Post-cardiac catheterization access site complications and low-molecular -weight heparin following cardiac catheterization.
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.
MacDonald
Lee A
LA
Division of Cardiology, Department of Meidcine, Northwestern Memorial Hospital Medical School, Chicago, IL 60611, USA. cdavidso@nmh.org
Meyers
Sheridan
S
Bennett
Charles L
CL
Fintel
Dan
D
Grosshans
Neal
N
Syegco
Raffy
R
Davidson
Charles J
CJ
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
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight