wetenschapsdag 2023 | 45 Sessie 1c: We Zullen Doorgaan x6 Auteurs M. Hoebink, L.C. Roosendaal, M.J. Beverloo, A.M. Wiersema, T. van der Ploeg, T.A.H. Steunenberg, K.K. Yeung & V. Jongkind Abstract titel Clinical outcomes of 5 000 IU heparin versus activated clotting time guided heparinization during non-cardiac arterial procedures: a propensity score matched analysis. Background This study investigated clinical outcomes of 100 IU/kg heparin followed by Activated Clotting Time (ACT) guided heparinization in comparison to a standardized bolus of 5 000 IU heparin during non-cardiac arterial procedures (NCAP). Methods A retrospective cohort analysis from a prospectively collected database of patients undergoing NCAP in two vascular centers was performed. Patients receiving ACT guided heparinization were matched 1 : 1 with patients receiving 5 000 IU heparin, using propensity score matching (PSM). Primary outcomes were thrombo-embolic complications (TEC), mortality and bleeding complications within 30 days of procedure or during the same admission. Results 759 patients (5 000 IU heparin: 213 patients, ACT guided heparinization: 546 patients) were included. PSM resulted in 209 patients included per treatment group. After PSM groups were comparable, with the exception of a higher prevalence of peripheral arterial disease in the ACT guided heparinization group (p = .039). There was no significant difference between patients receiving ACT guided heparinization and standard 5 000 IU heparin for TEC (6.2% vs. 4.8%, p = .52), mortality (1.4% vs. 0%) or bleeding complications (15% vs. 12%, p = .25). Multivariate logistic regression identified female sex, preoperative anaemia (men: < 8.1 mmol/L, women: < 7.5 mmol/L), chronic kidney disease (eGFR < 60 ml/min) and open abdominal aortic aneurysm surgery as predictors for bleeding complications. Patients undergoing carotid surgery or EVAR had a lower probability of bleeding complications. Conclusion No difference in TEC, bleeding complications and mortality between ACT guided heparinization and a single bolus of 5 000 IU heparin was found during NCAP.
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