Comparison of fixed dose versus weight-adjusted heparin on the prevention of radial artery occlusion after diagnostic transradial catheterization.

Abstract

Objectives: Transradial access (TRA) catheterization has demonstrated significant reductions in procedural complications compared with other access routes. However, radial artery occlusion (RAO) remains a concern, and the optimal dose of heparin to mitigate RAO has yet to be determined. This study aims to address this gap by investigating the impact of weight-adjusted heparin doses on the incidence of RAO in patients undergoing diagnostic transradial catheterization.

Methods: This study is a subanalysis of a multicenter, prospective, randomized trial evaluating heparin dosing strategies in 1494 patients undergoing diagnostic transradial catheterization. All participants received a standard fixed dose of 5000 IU of heparin at the start of the procedure, with additional analyses stratifying patients by weight-adjusted heparin doses. RAO was assessed using Doppler ultrasound within 12 hours post-procedure.

Results: Patients were grouped by weight-adjusted heparin quartiles: less than 58.14 IU/kg (Quartile 1), 58.14 to 65.79 IU/kg (Quartile 2), 65.79 to 74.63 IU/kg (Quartile 3), and greater than 74.63 IU/kg (Quartile 4). The incidence of RAO was similar across groups (2.1%, 2.6%, 2.8%, and 3.0%, respectively; P = .86). Comparisons of extreme dosages (less than 50 IU/kg vs greater than 80 IU/kg) also revealed no significant differences (1.9% vs 2.5%; P = .71). No major bleeding events were reported, and hematoma rates were consistent across groups.

Conclusions: Heparin doses adjusted by weight did not significantly influence the incidence of RAO when a baseline dose of 5000 IU was maintained. These findings reinforce the safety and efficacy of using 5000 IU heparin during diagnostic TRA procedures.