Periprocedural prophylactic antithrombotic strategies in interventional radiology: Current practice in the netherlands and comparison with the United Kingdom

Arno M. Wiersema*, Jan-Albert Vos, Cornelis M.A. Bruijninckx, Otto M. van Delden, Michel M.P.J. Reijnen, Anco Vahl, Clark J. Zeebregts, Frans L. Moll

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

14 Citations (Scopus)

Abstract

Purpose: The use of prophylactic antithrombotic drugs to prevent arterial thrombosis during the periprocedural period during (percutaneous) peripheral arterial interventions (PAIs) is still a matter of dispute, and clear evidence-based guidelines are lacking. To create those guidelines, a study group was formed in the Netherlands in cooperation with the Dutch Society of Vascular Surgery and the Society of Interventional Radiology. The study group is called "Consensus on Arterial PeriProcedural Anticoagulation (CAPPA)."

Materials and Methods: The CAPPA study group devised and distributed a comprehensive questionnaire amongst Dutch interventional radiologists (IRs). Results: One hundred forty-two IRs responded (68 %) to the questionnaire. Almost no IR stopped acetyl salicylic acid before interventions, and 40 % stopped clopidogrel before PAI but not before carotid artery stenting (CAS). A flushing solution on the sideport of the sheath was used routinely by 30 % of IRs in PAI and by 50 % of IRs during CAS. A minority of IRs used a heparinised flushing solution (28 %). Unfractionated heparin was used by 95 % of IRs as bolus; 5000 IU was the most used dosage. Timing of administration varied widely. A majority of IRs (75 %) repeated heparin administration after 1 h.

Conclusion: A substantial variety exists amongst IRs in the Netherlands regarding the use of prophylactic periprocedural antithrombotic drugs to prevent arterial thrombosis during PAI. When compared with varying results regarding the use of heparin in the United Kingdom, the variety in the Netherlands showed a different pattern. The proven variety in these countries, and also between these countries, emphasises the need for authoritative studies to develop evidence-based practical guidelines.

Original languageEnglish
Pages (from-to)1477-1492
Number of pages16
JournalCardioVascular and Interventional Radiology
Volume36
Issue number6
DOIs
Publication statusPublished - 1 Dec 2013
Externally publishedYes

Keywords

  • Angioplasty/angiogram
  • Arterial intervention
  • Arteriosclerosis
  • Clinical practise
  • Endovascular treatment

Fingerprint

Dive into the research topics of 'Periprocedural prophylactic antithrombotic strategies in interventional radiology: Current practice in the netherlands and comparison with the United Kingdom'. Together they form a unique fingerprint.

Cite this