Artigo Revisado por pares

Systematic use of a collagen‐based vascular closure device immediately after cardiac catheterization procedures in 1,317 consecutive patients

2002; Wiley; Volume: 57; Issue: 4 Linguagem: Inglês

10.1002/ccd.10254

ISSN

1522-726X

Autores

Holger Eggebrecht, Michael Haude, Uta Woertgen, Axel Schmermund, Clemens von Birgelen, Christoph Naber, Dietrich Baumgart, Christoph Kaiser, Olaf Oldenburg, Thomas Bartel, Knut Kroeger, Raimund Erbel,

Tópico(s)

Acute Myocardial Infarction Research

Resumo

Abstract Despite recent advances in interventional cardiology, vascular access complications continue to be a significant problem. Conventional manual compression of the femoral access site is associated with prolonged immobilization and significant patient discomfort. We investigated the performance of a collagen‐based closure device applied immediately after catheterization and its complication rate in 1,317 consecutive patients undergoing cardiac catheterization or coronary angioplasty. Patients undergoing coronary angioplasty (n = 644) received more heparin than patients with diagnostic cardiac catheterization (n = 673; 9,675 ± 1,144 IU vs. 6,419 ± 2,211 IU; P < 0.0001). Deployment success rates of the closure device were comparable for patients undergoing diagnostic vs. interventional procedures (95.8% vs. 96.7%; P = 0.46). Complete hemostasis immediately after deployment of the device was achieved in > 90% of all patients, but was lower in the interventional group (93.7% vs. 90.6%; P = 0.05). Major complications including any vascular surgery, major bleeding requiring transfusion, retroperitoneal hematoma, thrombosis or loss of distal pulses, groin infections, significant groin hematoma, and death were observed in 0.53% of all patients, with no differences between diagnostic or interventional patients (0.62% vs. 0.45%; P = 0.953). Subgroup analysis revealed female gender as a predictor of access site complications. Systematic sealing of femoral access sites after both diagnostic and interventional procedures allows for immediate sheath removal with reliable hemostasis. The use of a collagen‐based closure device is associated with a low rate of clinically significant complications. Cathet Cardiovasc Intervent 2002;57:486–495. © 2002 Wiley‐Liss, Inc.

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