Bleeding Avoidance Strategies

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:58

Review

Dauerman, Harold L.¹  Rao, Sunil V.²  Resnic, Frederic S.³  Applegate, Robert J.⁴ 

[1] Univ Vermont, Div Cardiol, Coll Med, Burlington, VT 05401 USA

[2] Duke Clin Res Inst, Durham, NC USA

[3] Wake Forest Univ, Med Ctr, Winston Salem, NC USA

[4] Brigham & Womens Hosp, Boston, MA 02115 USA

关键词: bleeding;    PCI;    radial;    vascular closure device.;   

DOI  :  10.1016/j.jacc.2011.02.039

来源: Elsevier

【 摘 要 】

Bleeding complications after coronary intervention are associated with prolonged hospitalization, increased hospital costs, patient dissatisfaction, morbidity, and 1-year mortality. Bleeding avoidance strategies is a term incorporating multiple modalities that aim to reduce bleeding and vascular complications after cardiovascular catheterization. Recent improvements in the rates of bleeding complications after invasive cardiovascular procedures suggest that the clinical community has successfully embraced specific strategies and improved patient care in this area. There remains controversy regarding the efficacy, safety, and/or practicality of 3 key bleeding avoidance strategies for cardiac catheterization and coronary intervention: procedural (radial artery approach, safezone arteriotomy), pharmacological (multiple agents), and technological (vascular closure devices) approaches to improved access. In this paper, we address areas of consensus with respect to selected modalities in order to define the role of each strategy in current practice. Furthermore, we focus on areas of controversy for selected modalities in order to define key areas warranting cautious clinical approaches and the need for future randomized clinical trials in this area. (J Am Coll Cardiol 2011;58:1-10) (C) 2011 by the American College of Cardiology Foundation

【 授权许可】

Free