Low-molecular-weight heparin (reviparin) reduces the incidence of femoropopliteal in-stent stenosis : Preliminary results of an ongoing study

• Published in: Cardiovascular and interventional radiology Vol. 21; no. 5; pp. 375 - 379
• Main Authors: STRECKER, E.-P. K, GÖTTMANN, D, BOOS, I. B. L, VETTER, S
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01.09.1998; Berlin Springer Nature B.V
• Subjects: ACETYLSALICYLIC ACID; Adult; Aged; Aged, 80 and over; Angiography; Angioplasty; Angioplasty, Balloon - adverse effects; Ankle; Anticoagulants - administration & dosage; Arterial Occlusive Diseases - drug therapy; Arterial Occlusive Diseases - surgery; ARTERIES; Aspirin; Biological and medical sciences; BIOMEDICAL RADIOGRAPHY; Complications; Constriction, Pathologic - etiology; Constriction, Pathologic - prevention & control; Diseases of the cardiovascular system; DOSES; Female; Femoral Vein - surgery; Follow-Up Studies; Hemorrhage; HEPARIN; Heparin, Low-Molecular-Weight - administration & dosage; Humans; Implantation; Implants; Male; Medical imaging; Medical sciences; Middle Aged; MOLECULAR WEIGHT; Occlusion; PATIENTS; Popliteal Vein - surgery; Postoperative Period; Premedication; Preoperative Care; Prospective Studies; RADIOLOGY AND NUCLEAR MEDICINE; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Restenosis; Secondary Prevention; Stents; Stents - adverse effects; Surgical implants; SYMPTOMS; TANTALUM; Thromboembolism; Treatment Outcome; Vascular Patency - drug effects; Weight reduction; Human; Reviparin sodium; Endoprosthesis; Femoral artery; Treatment efficiency; Instrumentation therapy; Cardiovascular disease; Low molecular weight heparin; Popliteal artery; Anticoagulant; Stent; Incidence; Vascular disease; Prevention; Restenosis; Chemotherapy; Treatment; Complication; Heparin; High dose
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s002709900283

To examine the efficacy of the low-molecular-weight heparin, reviparin, for prevention of femoropopliteal stent restenosis. Forty-two patients who had implantation of flexible tantalum stents for the treatment of stenosis (n = 24) or occlusion (n = 18) of the femoral (n = 27) or popliteal (n = 15) arteries were included in this study protocol. An intraarterial bolus of 5000 IU heparin was given before percutaneous transluminal angioplasty (PTA), and in the case of stent implantation due to unsuccessful PTA, an additional dose of reviparin (3500 anti-factor Xa IU) was given. Postprocedurally, 10,500 anti-factor Xa IU of reviparin were administered intravenously over 24 hr, followed by 3500 anti-factor Xa IU subcutaneously twice a day for 23 days. Oral aspirin (100 mg/day) was prescribed for the long term. Follow-up criteria (maximum follow-up 37 months) were clinical symptoms, Doppler ankle arm indices, color and duplex sonography, and angiography for suspicion of restenosis. Early stent thromboses were not observed. Overall primary patency rate (PPR) was 88% +/- 6.0% (1 year) and 74% +/- 10.1% (2 years). Major hemorrhagic complications have not occurred. Reviparin administered in a high dose over a period of 24 days is a safe medication regimen and provides excellent patency rates after stent implantation.