ABSTRACT
This prospective randomized study was done to assess the safety of 4-hr ambulation after diagnostic cardiac catheterization with 8 French sheaths and catheters. In this selected group of patients, we found that early ambulation could be done without an increase in access site complications.
Subject(s)
Cardiac Catheterization , Early Ambulation , Adult , Aged , Cardiac Catheterization/instrumentation , Early Ambulation/adverse effects , Equipment Design , Female , Groin , Hematoma/etiology , Humans , Male , Middle AgedABSTRACT
BACKGROUND: Compression of the femoral artery to achieve hemostasis is necessary following angiographic and interventional cardiovascular procedures. OBJECTIVES: To evaluate length of time to hemostasis with manual versus mechanical compression of the femoral artery. METHODS: In a prospective study of 503 patients randomized into one of three groups, manual compression with a pressure dressing or vascular stasis button was used on groups 1 and 3, respectively. Mechanical compression with a pressure dressing was used on group 2. The length of time to hemostasis was measured in minutes. Demographic data, current medications, risk factors, laboratory values, and procedural data were analyzed. RESULTS: Mean time to hemostasis was 22 minutes with manual compression and 31 minutes with mechanical compression. Crossover from mechanical to manual compression to achieve hemostasis occurred in 21 of 168 patients (13%). CONCLUSIONS: Results of this study show that advantages of manual compression include shorter time to hemostasis, no requirement for special equipment, and the ability to remove arterial and venous sheaths simultaneously. Disadvantages include upper extremity fatigue and human resource considerations. If the operator is a nurse, the cost of compression increases and the ability to meet patient needs may be restricted. Although mechanical compression is a "hands free" approach, arterial hemostasis is prolonged, special equipment is required, and the total cost per procedure is higher.
Subject(s)
Femoral Artery , Hemostatic Techniques , Analysis of Variance , Equipment Design , Female , Hemostatic Techniques/adverse effects , Hemostatic Techniques/economics , Hemostatic Techniques/nursing , Humans , Male , Middle Aged , Prospective Studies , Time FactorsABSTRACT
This report describes a prospective randomized trial of 503 patients who underwent a cardiac catheterization or interventional procedure at a single institution. In an effort to study femoral complications postprocedure, we evaluated three methods of femoral artery hemostasis as well as 38 variables that were felt to potentially relate to local complications. Only a marginally significant relationship between the hemostasis method and complication rate was found. The factors that contributed to femoral artery complications were: restarting heparin postsheath removal, number of procedures done during one hospitalization, noncompliance of the patient with bedrest after the procedure, number of arterial punctures to initiate the procedure, and preprocedure treatment with corticosteroids.
