Heparin during Diagnostic Cerebral Angiography, Is It Safe? (P05.253)

Abstract

Objective: This study aimes at identifying the safety of different techniques in administering heparin during diagnostic cerebral angiography (DCA). Background Unfractionated heparin is commonly used during DCA to reduce thromboembolic complications. In heparin insensitive patients, pressurized heparinized saline is always connected to the arterial sheath. Further heparin bolus for DCA is employed by few interventionalist. We sought to identify if these different techniques impact outcomes. Design/Methods: We reviewed all DCA procedures in our database for the past 2 years. We excluded procedures which were immediately followed by neurointervention, spinal angiograms, and cases with insufficient documentation. Procedures divided into 3 groups, those received heparinized flush for the femoral artery sheath; those who received additional intravenous heparin bolus (3000-5000 IU); and those who had a second heparinized saline flush for the diagnostic catheter. Endpoints included any atheroembolic complications and serious groin complications (bleeding requiring a transfusion, retroperitoneal hemorrhage, or femoral artery tear requiring vascular repair). Results: The final cohort included 1143 DCA performed on 959 patients. Among those 1037 patients had heparinized saline flush for the groin sheath; 62 patients had received additional intravenous heparin bolus; and 44 patients had 2 heparinized flush lines without heparin bolus. The incidence of any atheroembolic complications occurred in 7 patients (0.6%) and any serious groin complications in 6 patients (0.5%). All of these complications occurred in those who had heparinized saline for the arterial sheath only compared to the other groups (P > 0.05). Conclusions: At our institution, the incidence of any complications with DCA was low. Furthermore, there was no statistical evidence that administration of intravenous heparin bolus or a second heparinized saline line would increased serious groin bleeding or cause less atheroembolic complications. Disclosure: Dr. Kitchener has nothing to disclose. Dr. Amer has nothing to disclose. Dr. Kaushal has nothing to disclose. Dr. Bienemann has nothing to disclose. Dr. Callison has nothing to disclose. Dr. Vora has nothing to disclose. Dr. Edgell has nothing to disclose.