Bleeding avoidance strategies. Consensus and controversy.

Published

Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Dauerman, HL; Rao, SV; Resnic, FS; Applegate, RJ

Published Date

  • June 28, 2011

Published In

Volume / Issue

  • 58 / 1

Start / End Page

  • 1 - 10

PubMed ID

  • 21700085

Pubmed Central ID

  • 21700085

Electronic International Standard Serial Number (EISSN)

  • 1558-3597

Digital Object Identifier (DOI)

  • 10.1016/j.jacc.2011.02.039

Language

  • eng

Conference Location

  • United States