Document Detail


Immediate ambulation following diagnostic coronary angiography procedures utilizing a vascular closure device (The Closer).
MedLine Citation:
PMID:  12454334     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We investigated the safety and efficacy of The Closer, a suture-mediated vascular closure device, to facilitate immediate ambulation after diagnostic coronary angiography. METHODS AND RESULTS: We identified 487 non-consecutive patients who were eligible for an immediate ambulation protocol following vascular closure after diagnostic coronary angiography. A total of 434 patients (89%) were allowed immediate ambulation (mean time, 6.3 +/- 2.4 minutes) and 34 patients (7%) were treated with intermediate duration bed rest (mean time, 105.2 +/- 55.3 minutes). Of the 34 patients treated with intermediate duration bed rest, ten had minor bleeding from the arterial access tract requiring 2 5 minutes of light compression and 24 were delayed secondary to physician preference. Nineteen patients (4%) failed to achieve hemostasis with The Closer. Outpatients were followed up at 24 hours, and inpatients were followed up the next morning. Four patients (0.8%) suffered recurrent femoral artery bleeds after initially successful vascular closure. Three recurrent bleeds occurred during the observation period in-hospital and one occurred 6 days after device deployment. At follow-up, no patients developed the following: hematoma > 4 cm, ipsilateral retroperitoneal bleed, arterio-venous fistula, pseudoaneurysm, access site infection or loss of distal pulses. No patients had lower extremity ischemia or required blood transfusion. CONCLUSION: Use of The Closer after diagnostic angiography with subsequent immediate ambulation is safe and effective for most patients. Overall, hemostasis was achieved in 96% of patients, with 89% of our patients able to ambulate immediately and 7% able to ambulate after intermediate duration bed rest.
Authors:
Christopher H Crocker; Kevin T Cragun; Farris K Timimi; Robert J Houlihan; Malcolm R Bell; Ryan J Lennon; Kirk N Garratt; David R Holmes; Henry H Ting
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  14     ISSN:  1042-3931     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-11-27     Completed Date:  2003-02-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  728-32     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Ambulatory Care
Cohort Studies
Coronary Angiography / methods*
Coronary Disease / diagnosis*
Early Ambulation*
Equipment Design
Equipment Safety
Female
Heart Catheterization / methods*
Hemostasis, Surgical / instrumentation*
Humans
Male
Middle Aged
Punctures
Retrospective Studies
Sensitivity and Specificity
Surgical Instruments
Suture Techniques / instrumentation*
Time Factors
Comments/Corrections
Comment In:
J Invasive Cardiol. 2002 Dec;14(12):733-4   [PMID:  12454335 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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