PMID- 21698505
OWN - NLM
STAT- MEDLINE
DCOM- 20120730
LR  - 20120119
IS  - 1432-086X (Electronic)
IS  - 0174-1551 (Linking)
VI  - 35
IP  - 1
DP  - 2012 Feb
TI  - Antiplatelet and anticoagulant drugs in interventional radiology.
PG  - 30-42
LID - 10.1007/s00270-011-0204-0 [doi]
AB  - In treating peripheral arterial disease, a profound knowledge of antiplatelet and 
      anticoagulative drug therapy is helpful to assure a positive clinical outcome and 
      to anticipate and avoid complications. Side effects and drug interactions may 
      have fatal consequences for the patient, so interventionalists should be aware of 
      these risks and able to control them. Aspirin remains the first-line agent for 
      antiplatelet monotherapy, with clopidogrel added where dual antiplatelet therapy 
      is required. In case of suspected antiplatelet drug resistance, the dose of 
      clopidogrel may be doubled; prasugrel or ticagrelor may be used alternatively. 
      Glycoprotein IIb/IIIa inhibitors (abciximab or eptifibatide) may help in cases of 
      hypercoagulability or acute embolic complications. Desmopressin, tranexamic acid, 
      or platelet infusions may be used to decrease antiplatelet drug effects in case 
      of bleeding. Intraprocedurally, anticoagulant therapy treatment with 
      unfractionated heparin (UFH) still is the means of choice, although low 
      molecular-weight heparins (LMWH) are suitable, particularly for 
      postinterventional treatment. Adaption of LMWH dose is often required in renal 
      insufficiency, which is frequently found in elderly patients. Protamine sulphate 
      is an effective antagonist for UFH; however, this effect is less for LMWH. Newer 
      antithrombotic drugs, such as direct thrombin inhibitors or factor X inhibitors, 
      have limited importance in periprocedural treatment, with the exception of 
      treating patients with heparin-induced thrombocytopenia (HIT). Nevertheless, 
      knowing pharmacologic properties of the newer drugs facilitate correct bridging 
      of patients treated with such drugs. This article provides a comprehensive 
      overview of antiplatelet and anticoagulant drugs for use before, during, and 
      after interventional radiological procedures.
FAU - Altenburg, Alexander
AU  - Altenburg A
AD  - Department of Diagnostic and Interventional Radiology, HELIOS Klinikum Wuppertal, 
      University Hospital Witten/Herdecke, 42283 Wuppertal, Germany.
FAU - Haage, Patrick
AU  - Haage P
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20110623
PL  - United States
TA  - Cardiovasc Intervent Radiol
JT  - Cardiovascular and interventional radiology
JID - 8003538
RN  - 0 (Anticoagulants)
RN  - 0 (Platelet Aggregation Inhibitors)
SB  - IM
MH  - Anticoagulants/adverse effects/*therapeutic use
MH  - Drug Resistance
MH  - Humans
MH  - Peripheral Vascular Diseases/drug therapy/*therapy
MH  - Platelet Aggregation Inhibitors/adverse effects/*therapeutic use
MH  - *Radiography, Interventional
EDAT- 2011/06/24 06:00
MHDA- 2012/07/31 06:00
CRDT- 2011/06/24 06:00
PHST- 2011/01/11 00:00 [received]
PHST- 2011/05/22 00:00 [accepted]
PHST- 2011/06/24 06:00 [entrez]
PHST- 2011/06/24 06:00 [pubmed]
PHST- 2012/07/31 06:00 [medline]
AID - 10.1007/s00270-011-0204-0 [doi]
PST - ppublish
SO  - Cardiovasc Intervent Radiol. 2012 Feb;35(1):30-42. doi: 
      10.1007/s00270-011-0204-0. Epub 2011 Jun 23.