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Bivalirudin used as alternative anticoagulant in carotid artery stenting: a single center observational study

Purpose: To analyze and report the safety and effectiveness of bivalirudin in a large patient population undergoing carotid artery stenting (CAS). Methods: Between January 2001 and November 2010 extracranial CAS was performed in 272 patients in our institution. These patients were stratified accordi...

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1. Verfasser: Geisbüsch, Philipp (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2012
In: Journal of vascular and interventional radiology
Year: 2011, Jahrgang: 25, Heft: 2, Pages: 197-202
ISSN:1535-7732
DOI:10.1111/j.1540-8183.2011.00684.x
Online-Zugang:Verlag, Volltext: http://dx.doi.org/10.1111/j.1540-8183.2011.00684.x
Verlag, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1540-8183.2011.00684.x
Volltext
Verfasserangaben:Philipp Geisbüsch, M.D.; Barry T. Katzen,M.D.; Constantino Peña, M.D.; James F. Benenati, M.D.; and Heiko Uthoff, M.D.

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520 |a Purpose: To analyze and report the safety and effectiveness of bivalirudin in a large patient population undergoing carotid artery stenting (CAS). Methods: Between January 2001 and November 2010 extracranial CAS was performed in 272 patients in our institution. These patients were stratified according to the anticoagulant used during the CAS procedure into 2 groups (bivalirudin n = 217 vs. unfractionated heparin [UFH] n = 55) and analyzed regarding bleeding complications and periprocedural (within 30 days) stroke and myocardial infarction (MI) rates. Results: The combined end-point of death, stroke, and MI occurred in 12 patients (4.4%) with no significant difference between the groups (bivalirudin 4.6% vs. UFH 3.6% P value 0.96). Stroke rates were 1.8% in the bivalirudin and 1.8% in the UFH group (P value 1.00), with 4/5 strokes being nondisabling. Periprocedural MI was observed in 7 patients (2.1%) with no significant differences between the groups (bivalirudin 2.7% vs. UFH 1.8%, P value 0.94). Bleeding complications occurred in 13/272 patients (4.7%) with no significant difference between the groups (bivalirudin 3.6% vs. UFH 9.0%, P value 0.15). The first activated clotting time after administration of the anticoagulants was therapeutic in 209/217 (96%) in the bivalirudin group and in 30/55 (55%) in the UFH group (P < 0.001). Conclusions: In this single-center study, bivalirudin was a safe and efficient anticoagulation strategy for CAS and could be considered a therapeutic alternative to UFH. (J Interven Cardiol 2012;25:197-202) 
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