Is activated clotting time necessary to guide sheath removal in heparinised patients undergoing endovascular intervention for peripheral vascular disease?

Introduction: The purpose was to evaluate the best practice for arterial sheath management in heparinised patients undergoing endovascular intervention for peripheral vascular disease (PVD) at Eastern Health.

Methods: Patients undergoing endovascular intervention for PVD at Eastern Health between January 2016 and February 2018 were studied. Those who fulfilled the inclusion criteria were randomly assigned to five interventional radiologists and Category A (sheath removed upon return to recovery without activated clotting time (ACT)), Category B (ACT check 1-h postheparin and the sheath was removed without knowing the ACT) or Category C (ACT check 1-h postheparin and sheath removed once ACT < 160; our hospital's current protocol).