title: Safety and feasibility of intra-arterial bivalirudin bolus administration during primary angioplasty.
abstract: OBJECTIVE
  We investigated the feasibility and safety of intra-arterial bivalirudin bolus during primary angioplasty.
  
  
  BACKGROUND
  Bivalirudin has been shown to be an effective and safe anticoagulant during angioplasty. However, in the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction trial, the bivalirudin group experienced higher acute stent thrombosis rate compared with the heparin and glycoprotein IIb/IIIa inhibitor group. One possible explanation is suboptimal systemic administration.
  
  
  METHODS
  To prevent this possibility and to potentially prevent acute stent thrombosis, we administered intra-arterial bivalirudin bolus during primary angioplasty in 100 consecutive patients.
  
  
  RESULTS
  Our observational study suggests safety with no bleeding episode and no observed acute stent thrombosis.
  
  
  CONCLUSIONS
  We conclude that intra-arterial bivalirudin bolus during primary angioplasty is safe and could ensure effective systemic delivery of bivalirudin.
authors.affiliation: Cardiac Catheterization Laboratory, St. Luke's-Roosevelt Hospital Center, New York, NY 10025, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Chorzempa
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Tamis
authors.forename: Claude
authors.initials: C
authors.lastname: Simon
authors.forename: Angela
authors.initials: A
authors.lastname: Palazzo
authors.forename: Robert
authors.initials: R
authors.lastname: Leber
authors.forename: David
authors.initials: D
authors.lastname: Coven
authors.forename: Mun K
authors.initials: MK
authors.lastname: Hong
mesh_terms: D000368:Aged; D000991:Antithrombins / Q000008:administration & dosage* / Q000009:adverse effects; D003328:Coronary Thrombosis / Q000209:etiology / Q000517:prevention & control*; D005240:Feasibility Studies; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced; D006629:Hirudins / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007262:Infusions, Intravenous; D007269:Injections, Intra-Arterial; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D010446:Peptide Fragments / Q000008:administration & dosage* / Q000009:adverse effects; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects; D015607:Stents; D016896:Treatment Outcome
chemical_list: D000991:Antithrombins; D006629:Hirudins; D010446:Peptide Fragments; D011994:Recombinant Proteins; C074619:bivalirudin