A retrospective study on the use of heparin for peripheral vascular intervention

Purpose: To compare immediate outcomes for patients who receive and those who do not receive heparin during lower limb endovascular intervention.

Methods: A retrospective case series of 330 procedures for lower limb peripheral arterial occlusive disease. Patient records were interrogated for bleeding or thrombotic/embolic complications during or immediately after endovascular intervention for peripheral arterial occlusive disease.

Results: Of the 220 patients who received heparin, 21 (9.6%) suffered an access site bleed compared with 2 of the 110 patients (2%) who did not receive heparin (odds ratio [OR] = 5.7; 95% confidence interval [CI] = 1.3-25; P =.01). There were 6 embolic/thrombotic complications in the patients who received heparin (2.7%) compared with 4 in those that did not receive heparin (3.6%; P =.74). In 187 cases, a closure or compression device was used (StarClose, n = 109; Angio-Seal, n = 42; FemoStop, n = 35; ProGlide, n = 1), of which there were 3 access bleeding complications (2%). One hundred and forty-three cases did not have a closure or compression device associated with 17 (12%) access bleeding complications (OR = 0.25; 95% CI = 0.09-0.64; P =.004).

Conclusions: In this study, heparin use and nonuse of a closure or compression device was associated with an increased risk of access site bleeding. Embolic/thrombotic complications were uncommon.