Enoxaparin used in transcutaneous coronary interventions

Purpose: To evaluate the efficiency of transcutaneous coronary intervention (TCI) in combination with stenting on the basis of low molecular weight heparin (LMWH), enoxaparin, as an alternative to unfractionated heparin (UFH). Methods: 94 coronary heart disease (CHD) patients underwent TCI with stenting during this study. They were divided into 2 groups according to the type of antithrombotic therapy used intraoperatively: transcutaneous administration of enoxaparin (n=46) in the dose of 1 mg/kg and a conventional scheme of heparinization (UFH) (n=48). All patients received additional acetylsalicylic acid and clopidogrel in a standard dose. Immediate, short-term (1-month) and long-term (12 months) results have been evaluated. Results: All TCI could be considered as successful. In the course of TCI application no acute thrombosis of the stented artery was observed. Enoxaparin allowed for removing the introducers from the femoral artery without additional regulation of the coagulation level faster as compared to UFH. There was no profuse bleeding. The enoxaparin group showed a significantly lower number of minor hemorrhages, which reduced the patients' stay at the hospital. Neither subacute thrombosis of the stents nor unfa-vorable cardiac events happened in 1 or 12 months after TCI. Conclusions: A simplified effective and safe technique for using TCI against the background of enoxaparin administered in accordance with the appropriate scheme before the procedure involves refusal from further heparinization of patients when putting them in the X-ray operation room. This method allows an early removal of introducers without additional laboratory control and without increasing the number of hemorrhagic complications resulting from punctures, as well as the total time of hospital stay.