Post-cardiac catheterization access site complications and low-molecular -weight heparin following cardiac catheterization.

Authors:
  • LMLee A Macdonald
    Lee A Macdonald
  • SMSheridan Meyers
    Sheridan Meyers
  • CBCharles L Bennett
    Charles L Bennett
  • DFDan Fintel
    Dan Fintel
  • NGNeal Grosshans
    Neal Grosshans
  • RSRaffy Syegco
    Raffy Syegco
  • CDCharles J Davidson
    Charles J Davidson
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  • 1 February 2003
    • journal article
    • research article
Abstract
The low molecular weight heparin enoxaparin is often administered to patients on long-term anticoagulation regimens who temporarily discontinue warfarin prior to undergoing invasive procedures. The clinical outcome of all enoxaparin-treated patients who underwent cardiac catheterization or coronary artery interventional procedures (n = 119) was evaluated. A total of 5 patients (4.2%) requiring anticoagulation (3 with chronic atrial fibrillation and 2 with ventricular thrombi) developed severe late enoxaparin-associated hemorrhagic or vascular complications at the femoral arterial puncture site between 3 and 11 days post-procedure. Complications included development of femoral arterial pseudoaneurysm (n = 3), hypotension (systolic blood pressure < 90 mmHg) (n = 2), acute decrease in hemoglobin levels to < 8.5 mg/dl (n = 4) and cardiac arrest (n = 1). In patients receiving standard dose enoxaparin after percutaneous invasive cardiac procedures, there is the potential for delayed and severe access site hemorrhagic and vascular complications.