The Journal of invasive cardiology
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The activated clotting time (ACT) has been reported to be sensitive to the anticoagulant activity of the low-molecular weight heparin dalteparin following intravenous (IV) administration. ⋯ ACT-guided dose adjustment of intravenously administered dalteparin during PCI appears to constitute a feasible strategy.
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Case Reports
Percutaneous arterial closure for inadvertent cannulation of the subclavian artery--a call for caution.
An uncommon occurrence during central venous catheterization, inadvertent arterial sheath placement can cause potentially serious complications. When the subclavian artery is inadvertently cannulated, catheter removal may be complicated by significant hemorrhage due to its noncompressible location. ⋯ Prompt angiography and balloon inflation via an already present sheath in the brachiocephalic artery resulted in restoration of flow and successful closure at the puncture site with the collagen-based vascular closure device was confirmed. This averted an otherwise urgent surgical sheath removal and arteriotomy repair in an extremely high-risk patient who was deemed a poor candidate for open surgical repair.