Journal of Vascular Surgery
Volume 51, Issue 3 , Pages 559-564.e1 , March 2010

Protamine reduces bleeding complications associated with carotid endarterectomy without increasing the risk of stroke

Presented at the Sixty-Third Annual Meeting of the Society for Vascular Surgery, Denver, Colorado, June 13, 2009.

  • David H. Stone, MD

      Affiliations

    • Section of Vascular Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH
    • Corresponding Author InformationReprint requests: David H. Stone, MD, Section of Vascular Surgery, Dartmouth-Hitchcock Medical Center, One Medical Center Dr., Lebanon, NH 03756
    • ,
  • Brian W. Nolan, MD

      Affiliations

    • Section of Vascular Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH
    • The Dartmouth Institute for Health Policy and Clinical Practice, Center for Leadership and Improvement, Worcester, Me
    • ,
  • Andres Schanzer, MD

      Affiliations

    • The University of Massachusetts Medical School, Mass, Me
    • ,
  • Philip P. Goodney, MD

      Affiliations

    • Section of Vascular Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH
    • ,
  • Robert A. Cambria, MD

      Affiliations

    • Eastern Maine Medical Center, Bangor, Me
    • ,
  • Donald S. Likosky, PhD

      Affiliations

    • The Dartmouth Institute for Health Policy and Clinical Practice, Center for Leadership and Improvement, Worcester, Me
    • ,
  • Daniel B. Walsh, MD

      Affiliations

    • Section of Vascular Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH
    • ,
  • Jack L. Cronenwett, MD

      Affiliations

    • Section of Vascular Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH
    • ,
  • Vascular Study Group of Northern New England

Received 12 August 2009 ,Accepted 2 October 2009.

  • Image Result

    Reoperation for bleeding. Reoperation for bleeding was reduced three-fold in patients receiving protamine.

    Reoperation for bleeding. Reoperation for bleeding was reduced three-fold in patients receiving protamine.

  • Image Result

    Thrombotic complications. There were no observed significant differences in the incidence of major thrombotic complications, including MI, stroke, and death between protamine-treated and untreated pat

    Thrombotic complications. There were no observed significant differences in the incidence of major thrombotic complications, including MI, stroke, and death between protamine-treated and untreated patients.

  • Image Result
    Consequences of reoperation for bleeding. Regardless of protamine use, the consequences of reoperation for bleeding were significant. Patients who required reoperation for bleeding had a significantly

    Consequences of reoperation for bleeding. Regardless of protamine use, the consequences of reoperation for bleeding were significant. Patients who required reoperation for bleeding had a significantly higher risk of MI, stroke, and death, compared with patients without this bleeding complication.

 Competition of interest: none.

 Additional material for this article may be found online at www.jvascsurg.org.

 The editors and reviewers of this article have no relevant financial relationships to disclose per the JVS policy that requires reviewers to decline review of any manuscript for which they may have a competition of interest.

PII: S0741-5214(09)02132-6

doi: 10.1016/j.jvs.2009.10.078

Journal of Vascular Surgery
Volume 51, Issue 3 , Pages 559-564.e1 , March 2010

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