Wang Huanhuan, Cui Cheng, Liu Dan, Liu Hongmei, Tian Tao, Liu Minghao, Zhang Bo, Zou Tongqiang, Gao Zhan, Gao Lijian, Liu Haibo
Department of Cardiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Department of Cardiology, Shihezi People's Hospital, The Third Affiliated Hospital of Shihezi University School of Medicine, Xinjiang, China.
Front Cardiovasc Med. 2025 Jan 6;11:1479506. doi: 10.3389/fcvm.2024.1479506. eCollection 2024.
To evaluate the safety of brachial artery (BA) sheath removal after heparin neutralization with a half dose of protamine immediately after percutaneous coronary intervention (PCI).
The clinical data of 209 consecutive patients who underwent PCI through the BA at Fu Wai Hospital between September 2019 and June 2024 were retrospectively collected. In group I, the brachial sheath was removed 4 h after the PCI procedure. In group II, circulating heparin was neutralized with a half dose of protamine sulfate, and the brachial sheath was removed immediately after the procedure.
There were no cases of acute stent thrombosis, nonfatal myocardial infarction or in-hospital mortality in either group. In group II, there were two cases of pseudoaneurysm, one of which was transfer to surgery and the other was manually compressed. No severe puncture site-related bleeding occurred. The levels of hemoglobin were similar between the two groups before and after the PCI procedure ( > 0.05).
The BA sheath can be safely removed immediately after PCI by neutralizing heparin with a half dose of protamine. But we still need to be vigilant about the occurrence of pseudoaneurysms.
评估经皮冠状动脉介入治疗（PCI）后立即用半剂量鱼精蛋白中和肝素后拔除肱动脉（BA）鞘管的安全性。
回顾性收集2019年9月至2024年6月在阜外医院经肱动脉行PCI的209例连续患者的临床资料。I组在PCI术后4小时拔除肱动脉鞘管。II组用半剂量硫酸鱼精蛋白中和循环中的肝素，并在术后立即拔除肱动脉鞘管。
两组均无急性支架血栓形成、非致死性心肌梗死或院内死亡病例。II组有2例假性动脉瘤，其中1例转手术治疗，另1例手法压迫。未发生严重的穿刺部位相关出血。两组PCI术前、术后血红蛋白水平相似（>0.05）。
PCI后立即用半剂量鱼精蛋白中和肝素可安全拔除BA鞘管。但仍需警惕假性动脉瘤的发生。
