Document Detail


Systematic use of a collagen-based vascular closure device immediately after cardiac catheterization procedures in 1,317 consecutive patients.
MedLine Citation:
PMID:  12455083     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  57     ISSN:  1522-1946     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-11-27     Completed Date:  2003-03-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  486-95     Citation Subset:  IM    
Copyright Information:
Copyright 2002 Wiley-Liss, Inc.
Affiliation:
Department of Cardiology, Center of Internal Medicine, University Hospital Essen, Essen, Germany. holger.eggebrecht@uni-essen.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects*,  instrumentation*
Collagen / adverse effects*,  therapeutic use*
Coronary Artery Disease / surgery*
Equipment Design
Female
Femoral Artery / surgery*
Heart Catheterization / adverse effects*,  instrumentation*
Hemostatic Techniques / adverse effects*,  instrumentation*
Humans
Male
Middle Aged
Postoperative Hemorrhage / etiology*,  prevention & control*
Prospective Studies
Time Factors
Chemical
Reg. No./Substance:
9007-34-5/Collagen
Comments/Corrections
Comment In:
Catheter Cardiovasc Interv. 2002 Dec;57(4):496   [PMID:  12455084 ]

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


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