Use of Bivalirudin for Anticoagulation in Interventional Cardiovascular Procedures

(整期优先)网络出版时间:2018-03-04
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Anticoagulationisimperativetoreducetheincidenceofthromboticcomplicationsinpatientsundergoingpercutaneousinterventionalcardiovascularprocedures;however,thisisattheexpenseofincreasedriskofbleeding.Theoptimalanticoagulationstrategyfortheseproceduresremainsunclear.Unfractionatedheparinisthemostcommonlyusedanticoagulantduringinterventionalprocedures,buthasseverallimitations,suchasrelativelyhighincidenceofbleedingevents,occurrenceofheparin-inducedthrombocytopenia,andaparadoxicalthromboticeffect.Contemporarystudieshavedemonstratedthatbivalirudindecreasestheoccurrenceofbleedingcomplications,butpotentiallyincreasestheriskofacutestentthrombosis.Thisreviewdiscussesthepharmacologyofbivalirudinanditscurrentclinicalapplicationinpatientsundergoingpercutaneouscoronaryinterventionandtranscatheteraorticvalvereplacementprocedures.