Download PDF
Semin intervent Radiol 2018; 35(05): 393-398
DOI: 10.1055/s-0038-1676329
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Pharmacology of Peripheral Arterial Disease in the Angio Suite: What Every Interventionalist Should Know

Micah M. Watts
1   Pennsylvania Vascular Institute, Philadelphia, Pennsylvania
› Author Affiliations
Further Information

Publication History

Publication Date:
05 February 2019 (online)

Also available at
    Permissions and Reprints

Abstract

Safe and effective treatment of peripheral arterial disease (PAD) and critical limb ischemia can be routinely performed in the angiography suite. A systematic understanding of the medications commonly used during these procedures is essential. This review discusses the traditional roles of the medications used in PAD procedures, the existing evidence basis for those roles, potential alternatives, and evolving techniques. Developing a familiarity with these medications can help improve outcomes and safety for the patients being treated.

Keywords

medications in PAD - peripheral arterial disease - pharmacology of PAD
 

  • References

  • 1 Criqui MH, Aboyans V. Epidemiology of peripheral artery disease. Circ Res 2015; 116 (09) 1509-1526
    CrossrefPubMedGoogle Scholar
  • 2 Aparajita R, Zayed MA, Casey K, Dayal R, Lee JT. Development and implementation of an introductory endovascular training course for medical students. Ann Vasc Surg 2011; 25 (08) 1104-1112
    CrossrefPubMedGoogle Scholar
  • 3 Kaufman JA. The interventional radiology/diagnostic radiology certificate and interventional radiology residency. Radiology 2014; 273 (02) 318-321
    CrossrefPubMedGoogle Scholar
  • 4 Fassoulaki A, Theodoraki K, Melemeni A. Pharmacology of sedation agents and reversal agents. Digestion 2010; 82 (02) 80-83
    CrossrefPubMedGoogle Scholar
  • 5 Donaldson M, Gizzarelli G, Chanpong B. Oral sedation: a primer on anxiolysis for the adult patient. Anesth Prog 2007; 54 (03) 118-128 , quiz 129
    CrossrefPubMedGoogle Scholar
  • 6 Brosh-Nissimov T, Ingbir M, Weintal I, Fried M, Porat R. Central nervous system toxicity following topical skin application of lidocaine. Eur J Clin Pharmacol 2004; 60 (09) 683-684
    CrossrefPubMedGoogle Scholar
  • 7 Eggleston ST, Lush LW. Understanding allergic reactions to local anesthetics. Ann Pharmacother 1996; 30 (7-8): 851-857
    CrossrefPubMedGoogle Scholar
  • 8 Pavlidakey PG, Brodell EE, Helms SE. Diphenhydramine as an alternative local anesthetic agent. J Clin Aesthet Dermatol 2009; 2 (10) 37-40
    PubMedGoogle Scholar
  • 9 Spinosa DJ, Harthun NL, Bissonette EA. , et al. Subintimal arterial flossing with antegrade-retrograde intervention (SAFARI) for subintimal recanalization to treat chronic critical limb ischemia. J Vasc Interv Radiol 2005; 16 (01) 37-44
    CrossrefPubMedGoogle Scholar
  • 10 Shawker TH, Kluge RM, Ayella RJ. Bacteremia associated with angiography. JAMA 1974; 229 (08) 1090-1092
    CrossrefPubMedGoogle Scholar
  • 11 Franco J, Motaganahalli R, Habeeb M, Wittgen C, Peterson G. Risk factors for infectious complications with angio-seal percutaneous vascular closure devices. Vascular 2009; 17 (04) 218-221
    CrossrefPubMedGoogle Scholar
  • 12 Ryan JM, Ryan BM, Smith TP. Antibiotic prophylaxis in interventional radiology. J Vasc Interv Radiol 2004; 15 (06) 547-556
    CrossrefPubMedGoogle Scholar
  • 13 Heikkinen L, Valtonen M, Lepäntalo M, Saimanen E, Järvinen A. Infrarenal endoluminal bifurcated stent graft infected with Listeria monocytogenes . J Vasc Surg 1999; 29 (03) 554-556
    CrossrefPubMedGoogle Scholar
  • 14 Soden PA, Zettervall SL, Ultee KHJ. , et al; Society for Vascular Surgery Vascular Quality Initiative. Dual antiplatelet therapy is associated with prolonged survival after lower extremity revascularization. J Vasc Surg 2016; 64 (06) 1633-1644.e1
    CrossrefPubMedGoogle Scholar
  • 15 Visonà A, Tonello D, Zalunardo B. , et al. Antithrombotic treatment before and after peripheral artery percutaneous angioplasty. Blood Transfus 2009; 7 (01) 18-23
    PubMedGoogle Scholar
  • 16 Singh P, Harper Y, Oliphant CS. , et al. Peripheral interventions and antiplatelet therapy: role in current practice. World J Cardiol 2017; 9 (07) 583-593
    CrossrefPubMedGoogle Scholar
  • 17 Hawkins IF, Caridi JG. Carbon dioxide (CO2) digital subtraction angiography: 26-year experience at the University of Florida. Eur Radiol 1998; 8 (03) 391-402
    CrossrefPubMedGoogle Scholar
  • 18 Delaney A, Carter A, Fisher M. The prevention of anaphylactoid reactions to iodinated radiological contrast media: a systematic review. BMC Med Imaging 2006; 6: 2
    CrossrefPubMedGoogle Scholar
  • 19 de Swart CA, Nijmeyer B, Roelofs JM, Sixma JJ. Kinetics of intravenously administered heparin in normal humans. Blood 1982; 60 (06) 1251-1258
    CrossrefPubMedGoogle Scholar
  • 20 Soleimannejad M, Aslanabadi N, Sohrabi B. , et al. Activated clotting time level with weight based heparin dosing during percutaneous coronary intervention and its determinant factors. J Cardiovasc Thorac Res 2014; 6 (02) 97-100
    PubMedGoogle Scholar
  • 21 Lindblad B. Protamine sulphate: a review of its effects: hypersensitivity and toxicity. Eur J Vasc Surg 1989; 3 (03) 195-201
    CrossrefPubMedGoogle Scholar
  • 22 Salter BS, Weiner MM, Trinh MA. , et al. Heparin-induced thrombocytopenia. J Am Coll Cardiol 2016; 67 (21) 2519-2532
    CrossrefPubMedGoogle Scholar
  • 23 Lehman SJ, Chew DP. Bivalirudin in percutaneous coronary intervention. Vasc Health Risk Manag 2006; 2 (04) 357-363
    CrossrefPubMedGoogle Scholar
  • 24 Grouzi E. Update on argatroban for the prophylaxis and treatment of heparin-induced thrombocytopenia type II. J Blood Med 2014; 5: 131-141
    PubMedGoogle Scholar
  • 25 Vavra KA, Lutz MF, Smythe MA. Recombinant factor VIIa to manage major bleeding from newer parenteral anticoagulants. Ann Pharmacother 2010; 44 (04) 718-726
    CrossrefPubMedGoogle Scholar
  • 26 Karnabatidis D, Spiliopoulos S, Tsetis D, Siablis D. Quality improvement guidelines for percutaneous catheter-directed intra-arterial thrombolysis and mechanical thrombectomy for acute lower-limb ischemia. Cardiovasc Intervent Radiol 2011; 34 (06) 1123-1136
    CrossrefPubMedGoogle Scholar
  • 27 Yahagi K, Otsuka F, Sakakura K. , et al. Pathophysiology of superficial femoral artery in-stent restenosis. J Cardiovasc Surg (Torino) 2014; 55 (03) 307-323
    PubMedGoogle Scholar
  • 28 Stangl PA, Lewis S. Review of currently available GP IIb/IIIa inhibitors and their role in peripheral vascular interventions. Semin Intervent Radiol 2010; 27 (04) 412-421
    Article in Thieme ConnectPubMedGoogle Scholar
  • 29 Mascelli MA, Lance ET, Damaraju L, Wagner CL, Weisman HF, Jordan RE. Pharmacodynamic profile of short-term abciximab treatment demonstrates prolonged platelet inhibition with gradual recovery from GP IIb/IIIa receptor blockade. Circulation 1998; 97 (17) 1680-1688
    CrossrefPubMedGoogle Scholar
  • 30 Furman MI, Frelinger III AL, Michelson AD. GPIIb/IIIa inhibitor-induced dethrombosis. J Thromb Thrombolysis 2004; 18 (01) 11-17
    CrossrefPubMedGoogle Scholar
  • 31 Clark TWI, Watts MM, Kwan TW. Percutaneous femoropopliteal recanalization using a completely transpedal/transtibial approach. Cardiovasc Intervent Radiol 2016; 39 (12) 1750-1758
    CrossrefPubMedGoogle Scholar
  • 32 Walker CM, Mustapha J, Zeller T. , et al. Tibiopedal access for crossing of infrainguinal artery occlusions: a prospective multicenter observational study. J Endovasc Ther 2016; 23 (06) 839-846
    CrossrefPubMedGoogle Scholar
  • 33 Mustapha JA, Saab F, McGoff T. , et al. Tibio-pedal arterial minimally invasive retrograde revascularization in patients with advanced peripheral vascular disease: the TAMI technique, original case series. Catheter Cardiovasc Interv 2014; 83 (06) 987-994
    CrossrefPubMedGoogle Scholar
  • 34 Posham R, Biederman DM, Patel RS. , et al. Transradial approach for non-coronary interventions: a single-center review of safety and feasibility in the first 1500 cases. J Vasc Interv Radiol 2016; 27 (02) 159-166
    CrossrefPubMedGoogle Scholar
  • 35 Dharma S, Shah S, Radadiya R, Vyas C, Pancholy S, Patel T. Nitroglycerin plus diltiazem versus nitroglycerin alone for spasm prophylaxis with transradial approach. J Invasive Cardiol 2012; 24 (03) 122-125
    PubMedGoogle Scholar
  • 36 Candemir B, Kumbasar D, Turhan S. , et al. Facilitation of radial artery cannulation by periradial subcutaneous administration of nitroglycerin. J Vasc Interv Radiol 2009; 20 (09) 1151-1156
    CrossrefPubMedGoogle Scholar
  • 37 Katzenschlager R, Ugurluoglu A, Ahmadi A. , et al. Incidence of pseudoaneurysm after diagnostic and therapeutic angiography. Radiology 1995; 195 (02) 463-466
    CrossrefPubMedGoogle Scholar
  • 38 Mishra A, Rao A, Pimpalwar Y. Ultrasound guided percutaneous injection of thrombin: effective technique for treatment of iatrogenic femoral pseudoaneurysms. J Clin Diagn Res 2017; 11 (04) TC04-TC06
    PubMedGoogle Scholar