This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by D'Addio, V. J. Articles by Clagett, G. P. Search for Related Content PubMed Articles by D'Addio, V. J. Articles by Clagett, G. P. Social Bookmarking                         What's this?

Low-Molecular-Weight Heparin as Bridging Anticoagulation During Interruption of Warfarin: Assessment of a Standardized Periprocedural Anticoagulation Regimen

Division of Vascular and Endovascular Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, IX 75390-9157 victor.daddio{at}utsouthwestern.edu

G. Patrick Clagett, MD

Division of Vascular and Endovascular Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, IX 75390-9157

The safety and efficacy of a standardized periprocedural anticoagulation regimen with low -rnolecular-weight (LIH) heparin vvas studied n 650 cat-ients who hao eumbolic stroke, chronic atria! fibrillation, or a mechanical neart valve and required interrup ton of warfarin therapy because of an nvasive procedure. Warfarin was stopped 5 or 6 days before the procedure and NIH hepadin (subcutaneous dalteparin sodium' was begun 3 days before the procedure, Patients who had a procedure considered at low risk of bleeding and whose postprocedural hemostas:s was adequate resumed warfarin on the everrng of the procedure and dalteparin was resumed the Fext itay. Dalteparin was delayed if hemostasis was unstab e. Patients wino underwent a procedure at high risk of bleeding resurned warfarin or, the evening of the procedure but dalteparin was not given after the procedure. In 542 patients who underwernt a procedure at low risk for bleeding, 2 thromboermiulic events, 4 mrajor bleeding episodes, and 32 episodes of rncreased woulo-related blood loss occurred. In 108 patients who irder.vent a procedure at nigh risk for bleeding, 2 deaths and 2n rajor bleeding episodes occurred. The authors concluded that oatients at Increased risk for arterial thromboembalism a nd vho require temporary interruption of warfarin theray, J1VlH heparin was associated with a low risk of thromboernciiC and maior bleeding complications.

Key Words: venous thromboembolism • anticoagulation • bridgrg anticoagulation • LMWH • dalteparin

Perspectives in Vascular Surgery and Endovascular Therapy, Vol. 17, No. 2, 176-1-177 (2005)
DOI: 10.1177/153100350501700226


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?