Monitoring heparin anticoagulation in major vascular surgery

  • Research type

    Research Study

  • Full title

    Monitoring of heparin anticoagulation in major vascular surgery: correlation between ACT and anti Xa activity, inter-individual variation and patient outcomes

  • IRAS ID

    166835

  • Contact name

    Nick Schofield

  • Contact email

    n.schofield@nhs.net

  • Sponsor organisation

    Royal Free London NHS Trust

  • ISRCTN Number

    ISRCTN87607734

  • Duration of Study in the UK

    1 years, 0 months, 1 days

  • Research summary

    During vascular surgery to repair aortic aneurysms (swelling of the main large blood vessel from the heart), anticoagulation with a drug called heparin is commonly administered into the patient to reduce risk of blood clots during the surgery on the aorta. If too much heparin is given, the patient is at risk of excess bleeding, and if too little heparin is given, the patient is at risk of blood clots, during the operation.
    Heparin effects can be measured using a variety of tests including near patient tests (activated clotting time (ACT) and laboratory based tests (activated partial thromboplastin time (aPTT), antifactor Xa levels). All tests have their limitations and there remains much debate in the literature as to the best method of monitoring heparin anticoagulation. This study will compare conventional methods of heparin effects (ACT) with anti factor Xa tests, to ascertain what the best level of heparin is during aortic surgery.
    Aims of study:
    1) Correlate Hemochron ACT, anti Xa activity and antithrombin levels with paired blood samples taken from a cohort of vascular patients undergoing major vascular surgery with heparinisation.
    2) Report inter-individual variation in heparin response in our patient cohort.
    3) Report outcomes, including transfusion requirements and adverse events.

  • REC name

    HSC REC A

  • REC reference

    15/NI/0219

  • Date of REC Opinion

    27 Oct 2015

  • REC opinion

    Further Information Favourable Opinion