[Radial access and management of patients with long-term oral anticoagulation for cardiac catheterization]

Area of Science:

• Cardiology
• Interventional Cardiology
• Pharmacology

Context:

• Patients on long-term oral anticoagulation (OAC) have increased bleeding risk, especially during invasive procedures like angioplasty.
• Angioplasty and stenting in OAC patients necessitate careful management of antithrombotic therapy to mitigate bleeding and ischemic complications.
• Current guidelines lack specific recommendations for post-stenting antithrombotic regimens in OAC patients, posing a clinical challenge.

Purpose:

• To review current data on angioplasty and antithrombotic therapy in patients on long-term oral anticoagulation.
• To propose a treatment paradigm to optimize long-term prognosis for these high-risk patients.

Summary:

• Long-term oral anticoagulation increases bleeding risk during angioplasty, often leading to temporary therapy interruption.
• Balancing ischemic and bleeding risks post-stenting is challenging due to a lack of specific recommendations.
• Uninterrupted OAC, transradial approach, and risk stratification can minimize long-term complications.

Impact:

• Provides a comprehensive review of angioplasty management in OAC patients.
• Proposes a treatment strategy to improve long-term outcomes and reduce complications.
• Aims to guide clinicians in managing antithrombotic therapy for stented patients on long-term OAC.