Skip to content

Rivaroxaban Post-Transradial Access for the Prevention of Radial Artery Occlusion

Radial Artery Occlusion

Coronary angiography is performed to evaluate for obstructive coronary artery disease. This is commonly performed via the transfemoral or transradial approach with the latter increasing in frequency. One of the most common complications of transradial access is radial artery occlusion occurring in \~5% of patients which prohibits the use of the radial artery in the future. There is evidence to support the use of intraprocedural anticoagulation to mitigate the risk of radial artery occlusion however the role of post-procedural anticoagulation has not been previously evaluated. Rivaroxaban is a direct oral anticoagulant (DOAC) with a safety profile superior to that of vitamin K antagonists. Given the safety profile, ease of use, and feasibility of DOAC therapy, our study will endeavor to evaluate the use of rivaroxaban 15mg orally once daily for 7 days after transradial access and the impact this has on the rate of radial artery occlusion.

null

Conditions de participation

  • Sexe:

    ALL

  • Âges admissibles:

    18 and up

Critères de participation

Inclusion Criteria:

1. Willing and able to provide written informed consent
2. Age ≥ 18 years
3. Diagnostic coronary angiography or percutaneous coronary intervention via the transradial approach

Exclusion Criteria:

1. Presence of a palpable hematoma or clinical concern of hemostasis at the transradial access site
2. Access or attempted access at a second site - including contralateral radial artery, brachial, or femoral artery or vein
3. Planned staged procedure, CABG or noncardiac surgery within 30 days
4. Contraindication or high risk of bleeding with anticoagulation

1. bleeding requiring medical attention in the previous 6 months
2. thrombocytopenia (platelets\<50 x 109/L)
3. prior intracranial hemorrhage
4. use of IIb/IIIa during percutaneous coronary intervention
5. administration of thrombolytic therapy in the preceding 24 hours
6. use of non-steroidal anti-inflammatory medications
7. ischemic stroke or transient ischemic attack diagnosed in the last 3 months
5. Cardiogenic shock
6. Ventricular arrhythmias refractory to treatment
7. Liver dysfunction (Child-Pugh class B or C)
8. Unexplained anemia with a Hgb below 100 g/L
9. History of medication noncompliance or risk factor for noncompliance
10. Active malignancy
11. Allergy to rivaroxaban
12. Another indication for anticoagulation
13. CYP3A4 and P-glycoprotein inhibitor use
14. Life expectancy \<30 days
15. Women capable of pregnancy not on birth control
16. Chronic kidney disease with creatinine clearance of less than 30mL/min
17. History of antiphosphopholipid antibody syndrome

Lieu de l'étude

University of Ottawa Heart Institute
University of Ottawa Heart Institute
Ottawa, Ontario
Canada

Contactez l'équipe d'étude

Primary Contact

Benjamin Hibbert, MD PhD

Kingston Health Sciences Center
Kingston Health Sciences Center
Kingston, Ontario
Canada

Contactez l'équipe d'étude

Primary Contact

Brigita Zile, RN

613-549-6666
Étude parrainée par
Ottawa Heart Institute Research Corporation
Participants recherchés
Plus d'informations
ID de l'étude: NCT03630055