Bivalirudin: a direct thrombin inhibitor used during percutaneous coronary intervention.
Complications during percutaneous coronary intervention remain of great concern and in particular, intracoronary thrombus formation is an unwanted complication associated with mortality and morbidity. This has been prevented with the use of intense anticoagulant treatment, but often at the price of minor and major bleeding complications. Traditionally, unfractionated heparin has been used to prevent intracoronary thrombosis during balloon angioplasty and coronary stent implantation. However, there are several problems with the use of unfractionated heparin and recent data suggest that alternative anticoagulants, such as low-molecular-weight unfractionated heparin, or a direct thrombin inhibitor, may provide protection against ischemic events. The purpose of this article is to review the evidence for the use of bivalirudin, a direct thrombin inhibitor, during percutaneous coronary intervention.
University Hospital Rotterdam, Thoraxcenter BD 410P.O. Box 20403000 CA Rotterdam, The Netherlands. p.j.defeyter@erasmusmc.nl
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de Feyter