568
|
Vascular Disease Management - ISSN: 1553-8036 - Volume 3 - Issue 2 March/April 06 - March 2006 | |
|
|
| David E. Allie, MD, Chris J. Hebert, RT, RCIS and Craig M. Walker, MD |
|
|
Diagnosis and Non-Surgical Management of
Mesenteric Ischemia |
| Jaffar Ali Raza, MD, Michael Miller, MD, •Robert S. Dieter, MD, RVT, ••Leonardo C. Clavijo, MD, Michael C. Stoner, MD, Aravinda Nanjundappa, MD |
|
|
Current Clinical Applications of Bivalirudin: An Overview
|
| Nicolas W. Shammas, MS, MD |
Bivalirudin is a specific and reversible direct thrombin inhibitor with predictable anticoagulation. It is cleared by both proteolytic cleavage and renal mechanisms. Bivalirudin with provisional glycoprotein (GP) IIb/IIIa inhibition is indicated in elective contemporary percutaneous coronary interventions (PCI). It has been shown to be non-inferior to unfractionated heparin and planned GP IIb/IIIa inhibitors during PCI for the ischemic and hemorrhagic combined endpoints of death, myocardial infarction, unplanned urgent revascularization and major bleeding, including subgroups of patients with renal impairment and diabetes. In addition, bivalirudin has consistently been shown to have significantly less in-hospital major bleeding than heparin alone or heparin-GP IIb/IIIa inhibitor combination, and appears to be safe and effective in patients with heparin-induced thrombocytopenia and undergoing PCI. The role of bivalirudin in high-risk acute coronary syndrome patients is currently being t
|
|
|
