Local delivery of heparin post-PTCA: A multicenter randomized pilot study

Jean François Tanguay, Warren J. Cantor, Mitchell W. Krucoff, Brent Muhlestein, Gregory W. Barsness, James P. Zidar, Michael H. Sketch, James E. Tcheng, Harry R. Phillips, Richard S. Stack, Aaron V. Kaplan, E. Magnus Ohman

Research output: Contribution to journalArticlepeer-review

Abstract

Bailout stenting for major dissection and threatened closure has high rates of ischemic complications. We performed a randomized trial of local heparin delivery using the infusion sleeve before bailout stenting for suboptimal angioplasty results. In phase I, 20 patients were randomized to local delivery with either 40- or 100-psi infusion pressure. In phase II, 37 patients were randomized to local delivery at 100 psi or standard therapy. Local delivery succeeded in all but one patient; overall there was no significant worsening of intimal dissection. One patient treated with 100-psi drug infusion suffered a perforation after stent placement. There were no significant differences in the composite endpoint of death, MI, CABG, urgent repeat angioplasty, and stent thrombosis at 30 days (21% vs. 0%; P = 0.18). At 6 months, the rates of myocardial infarction in phase II were 27% with local delivery vs. 10% with standard treatment (P = 0.4). Local heparin delivery in dissected vessels may be associated with increased complications and should be approached with caution. (C) 2000 Wiley-Liss, Inc.

Original languageEnglish (US)
Pages (from-to)461-467
Number of pages7
JournalCatheterization and Cardiovascular Interventions
Volume49
Issue number4
DOIs
StatePublished - 2000

Keywords

  • Heparin
  • Local drug delivery
  • PTCA
  • Stents

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

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