Safety of transradial diagnostic cardiac catheterization in patients under oral anticoagulant therapy

Abstract Background Cardiac catheterization in anticoagulated patients is usually performed after the anticoagulation has been withdrawn, at least in the previous 48 h, and sometimes bridging therapy with heparin is used. Methods A prospective observational study including 489 patients undergoing transradial catheterization was conducted. A total of 140 patients were under acenocoumarol (group A) and they were compared with the remainder (group B) for complications after the procedure (bleeding and vascular access complications). Results Patients in group A were older (74 ± 12 years vs. 68 ± 17 years, p < 0.01) and the main indication for anticoagulation was atrial fibrillation (58.6%). No complications occurred during the procedures. There were no acute bleedings just after the bandage removal. During the first 24 h, only 3 (2.1%) radial occlusions in group A and 2 (0.6%) in group B ( p = 0.14) were recorded. Hematomas between 5 and 10 cm appeared in 5% of the group A vs. 4.6% in group B. During the 1-month follow-up period, one more radial occlusion in each group was recorded and there were 4 (1.1%) additional mild hematomas in group B and none in group A ( p = 0.48). Conclusions Performing a transradial diagnostic cardiac catheterization without removal of the oral chronic anticoagulation appears safe in patients under acenocumarol therapy.