Interventional procedures anticoagulant

Today, standard therapy for myocardial infarction or luminal narrowing includes thrombolytics, anticoagulants, and often interventional procedures such as PTCA. With its introduction... 

Epilogue Anticoagulant management of patients undergoing interventional procedures... 

The primary advantage of UFH as an anticoagulant is the relatively low unit cost and familiarity with its use and monitoring by staff members during the intervention. Another important consideration in the selection of UFH is the availability of a reversal agent, protamine, in an unfortunate event of major bleeding due to a procedural vascular perforation. 

The procedures may be performed under local anesthesia and mild sedation or general anesthesia with heparin anticoagulation. Aspirin (160mg, p.o.) and a loading dose of clopidogrel (300 mg, p.o.) are administered 24 hours before intervention for the aortic valve. Antibiotics (e.g., first generation cephalosporin, i.v.) are given before the procedure and continued for 48 hours, After the procedure aspirin is continued for three to six months,... 

A detailed written history of each CVC must be maintained, starting with its insertion, immediate postinsertion care, changes of exit site dressing, description of all complications and provided treatment and interventions. Appointing a CVC coordinator simplifies all this. Each center should also have an internal written policy and procedure document on CVC insertion and subsequent care. It should provide detailed description of standard actions in CVC handling and care (exit site care, composition of the anticoagulation lock and its administration, etc.) as well as all interventions used in the particular center. 

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