scholarly journals Efficacy of the hemostatic device VasoSTAT and the study of hemostatic factor

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hirokazu Naganawa ◽  
Akira Ito ◽  
Shinrou Saiki ◽  
Daisuke Nishi ◽  
Shinichi Takamatsu ◽  
...  
Keyword(s):  
Observational Study ◽  
Success Rate ◽  
Clotting Time ◽  
Common Procedure ◽  
Failure Group ◽  
Activated Clotting Time ◽  
Hemorrhagic Complications ◽  
Hemostatic Factor

AbstractRecently, trans-radial intervention has gained popularity as a common procedure to reduce hemorrhagic complications. However, the cuff-type hemostatic device (TR Band) previously used at our institution required 6 h to achieve hemostasis. Since July 2016, we have been using the VasoSTAT, a new hemostatic device that could achieve hemostasis in 4 h. In a verification study, we found that prolonged activated clotting time (ACT) was related to transient hemorrhage occurrence after the hemostatic procedure. Therefore, we designed a hemostatic protocol based on ACT and evaluated its efficacy. In this retrospective and observational study, 78 and 111 patients used the VasoSTAT and TR Band, respectively, from July 2015 to May 2017. In the VasoSTAT group, the ACTs were significantly lower in the hemostasis success (246 ± 46 s) than in the failure group patients (327 ± 59 s) (P < 0.01). Therefore, we applied the hemostatic protocol to 271 patients from May 2017 to March 2020. The hemostasis success rate was 96% in the post-protocol applied group patients, which was significantly higher than the 82% success rate in the pre-protocol applied group patients (P < 0.01). VasoSTAT resulted in adequate hemostasis in 4 h. Further, ACT was predictive of adequate hemostasis.

scholarly journals Relationship Between Activated Clotting Time and Ischemic or Hemorrhagic Complications

Circulation ◽  
2004 ◽  
Vol 110 (8) ◽  
pp. 994-998 ◽  
Author(s):  
Sorin J. Brener ◽  
David J. Moliterno ◽  
A. Michael Lincoff ◽  
Steven R. Steinhubl ◽  
Kathy E. Wolski ◽  
...  
Keyword(s):  
Clotting Time ◽  
Activated Clotting Time ◽  
Hemorrhagic Complications

scholarly journals Assessing Anticoagulation in Neonates With Congenital Diaphragmatic Hernia During Extracorporeal Membrane Oxygenation: Does Anti-Factor Xa or Thromboelastometry Provide Additional Benefit?

2021 ◽  
Vol 9 ◽  
Author(s):  
Alba Perez Ortiz ◽  
Carl E. Dempfle ◽  
Toni Jung ◽  
Thalia Doniga ◽  
Christel Weiß ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Factor Xa ◽  
Activated Partial Thromboplastin Time ◽  
Additional Benefit ◽  
Clotting Time ◽  
Heparin Dose ◽  
Activated Clotting Time ◽  
Hemorrhagic Complications ◽  
Thrombotic Complications

Objective: The optimal management of anticoagulation in neonatal/pediatric patients during extracorporeal membrane oxygenation (ECMO) has not been established yet and varies greatly among ECMO centers worldwide. Therefore, we aimed to assess whether the use of anti-factor Xa assay and/or thromboelastometry correlate better than activated clotting time with heparin dose in newborns with congenital diaphragmatic hernia during ECMO. We also examined whether these coagulation assays correlate with thrombotic and/or hemorrhagic complications, when the management of anticoagulation is based only on activated clotting time values.Methods: A prospective observational study in a neonatal ECMO center was conducted. We included all neonates with congenital diaphragmatic hernia born in our institution between March 2018 and January 2019 and requiring support with venoarterial ECMO. A total of 26 ECMO runs were analyzed. During the study, the heparin dose was still adjusted according to activated clotting time values. Measurements of anti-factor Xa assay, activated partial thromboplastin time, and a thromboelastometry from the same blood specimen were performed twice a day.Results: Anti-factor Xa levels showed a moderate correlation with heparin dose, whereas the other tests showed a weak correlation. Four patients (17.4%) had thrombotic complications, 2 patients (8.7%) experienced life-threatening bleeding, and in 11 patients (47.8%) disseminated intravascular coagulation (DIC) occurred. Anti-factor Xa levels were lower in the group with thrombotic complications (0.23 vs. 0.27 IU/ml; p = 0.002), while activated partial thromboplastin time was higher in the group with hemorrhagic complications (69.4 s vs. 59.8 s; p = 0.01). In patients experiencing DIC, heparin dose and anti-factor Xa levels were lower, while no difference in activated clotting time and clotting time in INTEM and INTEM-HEPTEM were shown.Conclusions: Anti-factor Xa levels correlate better to heparin dose than activated clotting time. The use of anti-factor Xa assay instead of activated clotting time for dosing of unfractionated heparin could reduce thrombotic complications in neonates with congenital diaphragmatic hernia on ECMO support. The thromboelastometry showed no additional benefit for this purpose.

Determinants of Abnormal Activated Clotting Time in Cardiac Catheterisation

2021 ◽  
Vol 30 ◽  
pp. S219
Author(s):  
J. Ramnarain ◽  
H. Rashid ◽  
C. Dowling ◽  
J. Ramzy ◽  
R. Gooley
Keyword(s):  
Cardiac Catheterisation ◽  
Clotting Time ◽  
Activated Clotting Time

Variability of Activated Clotting Time by Site of Sample Draw During Percutaneous Coronary Intervention: A Prospective Single-Center Study

Angiology ◽  
2021 ◽  
pp. 000331972199223
Author(s):  
Jacqueline H. Morris ◽  
Junsoo Alex Lee ◽  
Scott McNitt ◽  
Ilan Goldenberg ◽  
Craig R. Narins
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Unfractionated Heparin ◽  
Anticoagulation Therapy ◽  
Coronary Intervention ◽  
Clotting Time ◽  
Access Sheath ◽  
Arterial Blood ◽  
Activated Clotting Time ◽  
Guide Catheter ◽  
Percutaneous Coronary

The activated clotting time (ACT) assay is used to monitor and titrate anticoagulation therapy with unfractionated heparin during percutaneous coronary intervention (PCI). Observations at our institution suggested a considerable difference between ACT values drawn from varying arterial sites, prompting the current study. Patients undergoing PCI with unfractionated heparin therapy were prospectively enrolled. Simultaneous arterial blood samples were drawn from the access sheath and the coronary guide catheter. Differences between Hemochron ACT values were determined, and potential interactions with clinical variables were analyzed. Immediately postprocedure, the simultaneous mean guide and sheath ACTs were 327 ± 62 seconds and 257 ± 44 seconds, respectively, with a mean difference of 70 ± 60 seconds (P < .001). Nearly all (90%) ACT values obtained via the guide catheter were higher than the concurrent ACT drawn from the sheath. Logistic regression analysis demonstrated that lower weight-adjusted heparin doses and absence of diabetes were associated with a greater difference between the ACT values. We conclude that the ACT value is substantially greater when assessed via the guide catheter versus the access sheath. Although the biological mechanisms require further study, this difference should be considered when managing anticoagulation during PCI and when reporting ACT as part of research protocols.

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