Transradial Access and Bivalirudin Combination for Reducing Post-PCI Bleeding

Compounding the Bleeding Reduction Effects of Transradial PCI and Bivalirudin in a High-Risk Patient Undergoing Complex PCI

Transradial versus transfemoral percutaneous coronary intervention in acute coronary syndromes: re-evaluation of the current body of evidence.

Recent literature has argued the superiority of radial access compared with femoral access for percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS). Three particular trials-RIVAL (Radial Versus Femoral Access for Coronary Intervention), RIFLE-STEACS (Radial Versus Femoral Randomized Investigation in ST-Elevation Acute Coronary Syndrome), and STEMI-RADIAL (ST Elevation Myoca...

Bivalirudin versus unfractionated heparin: a meta-analysis of patients receiving percutaneous coronary intervention for acute coronary syndromes.

OBJECTIVE Acute coronary syndrome (ACS) encompasses ST segment elevation myocardial infarction (STEMI), with generally high thrombus burden and non-ST segment elevation ACS (NSTE-ACS), with lower thrombus burden. In the setting of percutaneous coronary intervention (PCI) for ACS, bivalirudin appears superior to unfractionated heparin (UFH), driven by reduced major bleeding. Recent trials sugges...

The Rise and Fall of Anticoagulation with Bivalirudin During Percutaneous Coronary Interventions: A Review Article

Bivalirudin is a direct thrombin inhibitor used during percutaneous coronary intervention (PCI). Treatment with bivalirudin compared to heparin plus glycoprotein IIb/IIIa inhibitors (GPI) reduced bleeding complications, but resulted in higher rates of ischemic events, including acute stent thrombosis in ST segment elevation myocardial infarction (STEMI) patients. Thus, it may be considered a re...

If you prick us, do we not bleed?

Women have higher post PCI bleeding complications which in turn contributes to higher post PCI mortality. Bivalirudin decreases bleeding events in both men and women when compared to use of both heparin and GPI but bleeding avoidance strategies such as radial artery access or avoiding GPI may modify that benefit. The NCDR bleeding risk score incorporates gender and is predictive of both bleedin...