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Title: Periprocedural Prophylactic Antithrombotic Strategies in Interventional Radiology: Current Practice in the Netherlands and Comparison with the United Kingdom

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 varietymore » 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.« less
 [1] ;  [2] ;  [3] ;  [4] ;  [5] ;  [6] ;  [7] ;  [8]
  1. Westfriesgasthuis, Hoorn, Department of Surgery (Netherlands)
  2. St Antonius Hospital, Nieuwegein, Department of Radiology, Division of Interventional Radiology (Netherlands)
  3. Equipe Zorg Bedrijven, Rotterdam, Department of Surgery (Netherlands)
  4. Academic Medical Centre, University of Amsterdam, Department of Radiology, Division of Interventional Radiology (Netherlands)
  5. Rijnstate Hospital, Arnhem, Department of Surgery (Netherlands)
  6. Onze Lieve Vrouwe Gasthuis, Amsterdam, Department of Surgery (Netherlands)
  7. University of Groningen, Department of Surgery, Division of Vascular Surgery, University Medical Centre Groningen (Netherlands)
  8. University of Utrecht, Department of Surgery, Division of Vascular Surgery, University Medical Centre Utrecht (Netherlands)
Publication Date:
OSTI Identifier:
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 36; Journal Issue: 6; Other Information: Copyright (c) 2013 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE);; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States