Management of haemostasis with combined use of vascular closure devices and bivalirudin - A review

Bleeding and vascular complications related to invasive cardiovascular procedures are associated with significant morbidity and mortality. The aim of this article is to evaluate the literature to determine haemostasis strategies in percutaneous coronary intervention when using bivalirudin with or without a vascular closure device. The literature data seem to underline that the combination of vascular closure devices and bivalirudin was associated with significantly lower bleeding rates. However, these strategies were less often used among high-risk patients. We recommend that prospective clinical studies are undertaken to determine the potential disadvantages of using vascular closure devices and bivalirudin in combination in high-risk patients.