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Iliac Endovascular Intervention Without Procedural Anticoagulation.

Burak Turan1, Murat Uğur1, Osman Muhsin Çelik1

  • 1Cardiology Department, Derince Training and Research Hospital, University of Health Sciences, Kocaeli, Turkey.

Vascular and Endovascular Surgery
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PubMed
Summary

Iliac artery interventions without anticoagulation are safe for non-complex lesions when patients use dual antiplatelet therapy (DAPT). This approach avoids complications and matches diagnostic procedure times.

Keywords:
anticoagulationendovascular interventionhepariniliac arteryperipheral artery disease

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Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Endovascular Interventions

Background:

  • Antithrombotic therapy is crucial for preventing thrombus during percutaneous endovascular interventions (PVI).
  • A hypothesis suggests that non-complex iliac artery lesions may not require procedural anticoagulation if patients are on dual antiplatelet therapy (DAPT).

Purpose of the Study:

  • To evaluate the safety and efficacy of performing iliac artery PVIs without procedural anticoagulation in patients on DAPT.
  • To compare the procedural times of iliac interventions without anticoagulation to diagnostic peripheral angiography procedures.

Main Methods:

  • Retrospective screening of 108 iliac PVIs performed without procedural anticoagulation between 2017 and 2021.
  • Collection and review of patient demographics, in-hospital events, and 30-day follow-up data.
  • Analysis of procedural details, thromboembolic events, and adverse vascular events.

Main Results:

  • A low rate of thrombotic findings (3.7%) was observed, primarily in patients with in-stent lesions.
  • No distal embolization, acute limb ischemia, or need for target vessel revascularization occurred at 30-day follow-up.
  • Procedure times for iliac interventions were comparable to lower extremity diagnostic procedures, with no major bleeding events.

Conclusions:

  • Percutaneous endovascular interventions for non-complex iliac artery lesions can be safely performed without procedural anticoagulation when patients are on DAPT.
  • These interventions can be completed within a timeframe similar to diagnostic procedures.
  • Avoidance of in-stent lesions during procedures without anticoagulation is recommended.