WARFARIN THERAPY NEED NOT BE INTERRUPTED FOR CORONARY INTERVENTIONS USING RADIAL
ARTERY ACCESS. C.N. Aroney. Cardiac Units, Prince Charles Hospital and John Flynn Hospital,
Queensland. Femoral artery access carries a significant risk of bleeding in patients
who are on warfarin especially if
peri-procedural heparin is used. Interruption of warfarin also carries a risk
of thromboembolism. The aim of this study was to establish if radial artery
access in patients undergoing angiography (Ang) or percutaneous coronary
intervention (PCI) could be performed safely without interruption of warfarin. Methods: 26
patients on warfarin underwent coronary interventions (20 - Ang; 6 - PCI) from
the radial artery without interruption of warfarin therapy. 18 patients were
male, mean age 66yrs (range: 39-82yrs). 16 patients had valvular heart disease.
All those having PCI had stents implanted and concomitant aspirin 100mg/day,
with the first 3 having
abciximab/ticlopidine and the last 3 having clopidogrel. In all patients the
sheath was removed immediately. Results: There were no significant
complications. One patient who had PTCA had minor oozing for 24 hours which was
easily controlled. No patients required fresh frozen plasma or other
transfusions, and all were mobilized immediately. 11 patients were discharged
the day of the procedure and 13 the following day. Conclusion: In patients on
warfarin, a radial approach may eliminate the need for its interruption and
allow early discharge without significant bleeding or embolic complications.
