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Optimal activated clotting time during peripheral artery endovascular procedures: cutting the gordian knot. | LitMetric

Optimal activated clotting time during peripheral artery endovascular procedures: cutting the gordian knot.

J Cardiovasc Surg (Torino)

Department of Interventional Radiology, Guy's and St. Thomas' NHS Trust, London, UK.

Published: June 2023

AI Article Synopsis

  • Effective anticoagulation is crucial for endovascular procedures to prevent thrombo-embolic complications caused by device manipulation.
  • There is a lack of clear evidence on the optimal use and monitoring of anticoagulant medications in peripheral arterial procedures, even though systemic heparinization is common.
  • Patient-specific factors and procedure details must be considered when deciding how to manage anticoagulation and monitor coagulative status throughout vascular procedures.

Article Abstract

All endovascular procedures need an effective anticoagulation regimen that avoids thrombo-embolic complications due to the insertion and manipulation of various intravascular devices. Systemic heparinization reduces the risk of thrombosis but there is no conclusive evidence regarding the correct use of anticoagulant medications and accordant monitoring, especially in endovascular peripheral arterial procedures. Anticoagulation must be maintained during the whole vascular procedure, especially during partial or complete blood flow interruption. Reaching and maintaining the correct coagulative status is mandatory to avoid or reduce thromboembolic complications that could limit the procedure's effectiveness or be harmful to the patient. Patients' baseline variables and procedure-related elements can influence the way anticoagulation should be administered and how coagulative status has to be monitored. This review aimed to clarify the critical points of anticoagulation and monitoring management for non-cardiac arterial procedures in order to understand the best way to manage vascular procedures anticoagulation.

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Source
http://dx.doi.org/10.23736/S0021-9509.23.12703-0DOI Listing

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