Safety of heparin reversal with protamin and immediate sheath removal after coronary angioplasty.
OBJECTIVE
To study the safety of giving protamin after coronary angioplasty to reverse heparin for immediate removal of the femoral sheath.


METHODS
After successful angioplasty, 100 patients were randomized to receive protamin and immediate sheath removal or to the control group with sheath removal after 3 h. Patients were followed for 30 days so that groin complications and coronary events could be compared. After 6 months, target vessel revascularization and death were recorded.


RESULTS
The time to mobilization was significantly shorter in the protamin group compared to the control group; 6 versus 19 h. The protamin patients were more satisfied than the control patients, in particular during bed rest after compression. Puncture site complications were one (2%) and two (4%) pseudoaneurysms in the protamin group and the control group, respectively. Early angina and restenosis/reocclusion before 30 days were seen in 4 patients in the protamin group and in 1 in the control group. Adverse incidents between 30 days and 6 months were the same for both groups.


CONCLUSIONS
Protamin reversal improved patient comfort and reduced immobilization time. The cardiac safety concern observed requires the antiplatelet agent clopidogrel to be given before the procedure.
Lohne
F
F
Faculty of Medicine, Department of Cardiovascular Radiology, Ullevål University Hospital, Oslo, Norway.
Kløw
N E
NE
Stavnes
S
S
Brekke
M
M
Hoffmann
P
P
Stensaeth
K H
KH
Søvik
E
E
Pettersen
M S
MS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D000925:Anticoagulants; D020878:Device Removal; D005260:Female; D005263:Femoral Artery; D006489:Hemostatic Techniques / Q000295:instrumentation*; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D007336:Insulin, Isophane / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011677:Punctures; D013997:Time Factors; D016896:Treatment Outcome
D000925:Anticoagulants; D007336:Insulin, Isophane; D006493:Heparin