Combined techniques reduce procedural bleeding during PCI

Published: 2010-06-30

A further good result has been obtained by bivalirudin, a specific and reversible direct thrombin inhibitor (DTI), in a large observational study [1]. It is a synthetic form of the leech enzyme hirudin and overcomes many limitations seen with indirect thrombin inhibitors, such as heparin.

Combination of vascular closure devices plus bivalirudin is associated with reduced peri-procedural bleeding in patients undergoing percutaneous coronary intervention (PCI). Bleeding is the most common non-cardiac complication of PCI, and has significant adverse effects on clinical outcome. The authors conclude that in this patient population undergoing PCI, vascular closure devices and bivalirudin were associated with significantly lower bleeding rates, particularly among patients at greatest risk for bleeding. Use of both strategies together was associated with lowest risk.

1. JAMA. 2010; 303(21): 2156-64