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Updated: Mar 25, 2026

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
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Risk-guided use of the direct thrombin inhibitor bivalirudin

William B Hillegass1,2

  • 1Heart South Cardiovascular Group, Alabaster, Alabama.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|February 27, 2016
PubMed

Mortality and bleeding risks after percutaneous coronary intervention (PCI) can be predicted with bedside models. Bivalirudin reduces access and non-access bleeding by almost half compared to heparin monotherapy and heparin with IIb/IIIa use. In high (>10%) baseline one-year mortality risk PCI patients, bivalirudin reduces mortality by 4% compared to heparin with IIb/IIIa therapy. Increased acute stent thrombosis may be resolved with a 4-hr post-procedure bivalirudin infusion, eliminating bivalirudin's only major drawback except cost.

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