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Safety and efficacy of fixed-dose heparin in carotid endarterectomy.

Authors
  • Poisik, A
  • Heyer, E J
  • Solomon, R A
  • Quest, D O
  • Adams, D C
  • Baldasserini, C M
  • McMahon, D J
  • Huang, J
  • Kim, L J
  • Choudhri, T F
  • Connolly, E S
Type
Published Article
Journal
Neurosurgery
Publication Date
Sep 01, 1999
Volume
45
Issue
3
Identifiers
PMID: 10493364
Source
Medline
License
Unknown

Abstract

Fixed heparin dosing achieves safe and efficacious anticoagulation in the great majority of patients having carotid endarterectomy, with 5000 U expected to result in 15-minute and 1-hour ACT values of 175 to 425 seconds and 170 to 390 seconds, respectively. Although weight-based heparin dosing may reduce the incidence of subtle complications (hematoma formation or decline on neuropsychometric tests) and may result in more predictable 15-minute and 1-hour ACT values (85 U/kg; 225-375 and 200-340 s, respectively), no statistically compelling clinical advantage could be demonstrated. Therefore, either weight-based or fixed dosing is acceptable, with both obviating the need for routine pre-clamp ACT confirmation, thereby saving operative time and expense.

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