{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T23:07:17Z","timestamp":1785539237201,"version":"3.56.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,3,3]],"date-time":"2025-03-03T00:00:00Z","timestamp":1740960000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,3,3]],"date-time":"2025-03-03T00:00:00Z","timestamp":1740960000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["CVIR Endovasc"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>The total amount of heparin administered through flush fluids in stroke patients is not considered in recent trials, possibly influencing main results. We investigated the use of heparin among treating physicians worldwide.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We conducted a survey from November 2022 to January 2023 to identify the variability of heparin administration during stroke endovascular treatment (EVT). We calculated the total heparin dose per hour (IU\/h) by adding the intravenous (IV)-bolus dose to the amount administered through flush fluids, calculated by a multiplication of the number of infusion bags, drip rate[mL\/h] and heparin concentration[IU\/L].<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A total of 315 participants from different countries worldwide completed the survey and 231\/315(73%) respondents administer heparin during EVT. The majority administered heparin only through flush fluids (168\/231; 72.7%), followed by both IV-bolus and flush fluids (36\/231; 16%), and those who used only an IV-bolus (27\/231; 11.7%). From the participants that administer heparin through flush fluids, the median heparin concentration was 2000\u00a0IU\/L (range:100\u00a0IU\/L-10000\u00a0IU\/L). The total heparin dose (administered through flush fluids and IV-bolus) among 23 respondents showed a median of 4650\u00a0IU\/h (IQR:3432\u20135900). Among the respondents who administer heparin through IV-bolus only, the median was 5250\u00a0IU (IQR:3750\u20137500).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>This survey revealed variable heparin doses administered by physicians worldwide during EVT and reflects the lack of international\u00a0guidelines.\u00a0Caution is warranted, specifically during complex\/long EVT procedures.\u00a0Furthermore,\u00a0heparin flush\u00a0doses should be considered in future trials regarding periprocedural anticoagulants, since imbalances could\u00a0potentially confound results.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s42155-025-00532-3","type":"journal-article","created":{"date-parts":[[2025,3,3]],"date-time":"2025-03-03T01:19:31Z","timestamp":1740964771000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The variable use of heparin through intravenous bolus and flush fluid systems during endovascular stroke treatment, a world-wide survey"],"prefix":"10.1186","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9494-160X","authenticated-orcid":false,"given":"Senta","family":"Frol","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faysal","family":"Benali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aymeric","family":"Rouchaud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robrecht R. M. M.","family":"Knapen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wim H.","family":"van Zwam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Research Committee of the European Society of Minimally Invasive Neurological Therapy (ESMINT)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,3]]},"reference":[{"issue":"5","key":"532_CR1","doi-asserted-by":"publisher","first-page":"750","DOI":"10.1007\/s00270-020-02726-9","volume":"44","author":"F Benali","year":"2021","unstructured":"Benali F, Hinsenveld WH, van der Leij C, Roozenbeek B, van de Graaf RA, Staals J, et al. Effect of Heparinized Flush Concentration on Safety and Efficacy During Endovascular Thrombectomy for Acute Ischemic Stroke: Results from the MR CLEAN Registry. Cardiovasc Intervent Radiol. 2021;44(5):750\u20135.","journal-title":"Cardiovasc Intervent Radiol"},{"issue":"1","key":"532_CR2","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1186\/s42155-021-00264-0","volume":"4","author":"F Benali","year":"2021","unstructured":"Benali F, van der Leij C, Staals J, van Zwam WH. Use of heparinized saline flush during endovascular thrombectomy for acute ischemic stroke; a survey of clinical practice in the Netherlands. CVIR Endovasc. 2021;4(1):76.","journal-title":"CVIR Endovasc"},{"issue":"10329","key":"532_CR3","doi-asserted-by":"publisher","first-page":"1059","DOI":"10.1016\/S0140-6736(22)00014-9","volume":"399","author":"W van der Steen","year":"2022","unstructured":"van der Steen W, van de Graaf RA, Chalos V, Lingsma HF, van Doormaal PJ, Coutinho JM, et al. Safety and efficacy of aspirin, unfractionated heparin, both, or neither during endovascular stroke treatment (MR CLEAN-MED): an open-label, multicentre, randomised controlled trial. Lancet. 2022;399(10329):1059\u201369.","journal-title":"Lancet"},{"key":"532_CR4","unstructured":"Benali F. Drip rate (drip\/sec), 5 videos. YouTube. https:\/\/www.youtube.com\/channel\/UCghPkZ0abySWPCIKB5Fqz9w. Published 2021. Accessed April 21, 2021."},{"key":"532_CR5","doi-asserted-by":"crossref","unstructured":"M Korzewski LM, K Schomer, K Van Leuven. Heparin Flush Use in Transfemoral Cerebral Angiography Survey. Journal of Radiology Nursing. 2020;39(3):199\u2013206.","DOI":"10.1016\/j.jradnu.2020.06.001"},{"issue":"12","key":"532_CR6","doi-asserted-by":"publisher","first-page":"e344","DOI":"10.1161\/STR.0000000000000211","volume":"50","author":"WJ Powers","year":"2019","unstructured":"Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, et al. 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Radiology. 1989;172(3 Pt 2):1007\u201311.","journal-title":"Radiology"},{"issue":"6","key":"532_CR9","doi-asserted-by":"publisher","first-page":"1477","DOI":"10.1007\/s00270-013-0558-6","volume":"36","author":"AM Wiersema","year":"2013","unstructured":"Wiersema AM, Vos JA, Bruijninckx CMA, van Delden OM, Reijnen M, Vahl A, et al. Periprocedural prophylactic antithrombotic strategies in interventional radiology: current practice in the Netherlands and comparison with the United kingdom. Cardiovasc Intervent Radiol. 2013;36(6):1477\u201392.","journal-title":"Cardiovasc Intervent Radiol"},{"key":"532_CR10","first-page":"1456298","volume":"2016","author":"AM Wiersema","year":"2016","unstructured":"Wiersema AM, Watts C, Durran AC, Reijnen MM, van Delden OM, Moll FL, et al. The Use of Heparin during Endovascular Peripheral Arterial Interventions: A Synopsis. 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An audit of fluid and heparin administration during interventional neuroradiologic procedures. J Neurosurg Anesthesiol. 2006;18(4):251\u20135.","journal-title":"J Neurosurg Anesthesiol"}],"container-title":["CVIR Endovascular"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42155-025-00532-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s42155-025-00532-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42155-025-00532-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,3]],"date-time":"2025-03-03T13:14:13Z","timestamp":1741007653000},"score":1,"resource":{"primary":{"URL":"https:\/\/CVIRendovasc.springeropen.com\/articles\/10.1186\/s42155-025-00532-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,3]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["532"],"URL":"https:\/\/doi.org\/10.1186\/s42155-025-00532-3","relation":{},"ISSN":["2520-8934"],"issn-type":[{"value":"2520-8934","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,3]]},"assertion":[{"value":"22 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 February 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 March 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The present research complies with the guidelines for human studies, and the research was conducted ethically in accordance with the World Medical Association Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"SF, FB, RRMMK report no disclosures. WWZ reports speaker fees for Stryker, Medtronic, Cerenovus, Microvention, Nicolab and consultancies for Philips and Bayer. AR reports consultancies for Medtronic, Balt, Microvention.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"17"}}