Format

Send to

Choose Destination
J Am Coll Cardiol. 2011 Jun 28;58(1):1-10. doi: 10.1016/j.jacc.2011.02.039.

Bleeding avoidance strategies. Consensus and controversy.

Author information

1
Division of Cardiology, University of Vermont College of Medicine, 111 Colchester Avenue, Burlington, VT 05401, USA. harold.dauerman@vtmednet.org

Abstract

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.

PMID:
21700085
PMCID:
PMC3127231
DOI:
10.1016/j.jacc.2011.02.039
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center