Early sheath removal after percutaneous coronary intervention using Assiut Femoral Compression Device is feasible and safe. Results of a randomized controlled trial

Objective: This study was performed to evaluate the feasibility and safety of early sheath removal after percutaneous coronary intervention (PCI) using a locally designed Assiut Femoral Compression Device (AFCD2) vs. manual compression (MC). Background: Due to antithrombotic therapy before, during,...

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Main Authors: Ayman K.M. Hassan, Hosam Hasan-Ali, Salwa R. Demetry, Randa Refaat, Ahmed S. Ali
Format: Article
Language:English
Published: SpringerOpen 2015-03-01
Series:The Egyptian Heart Journal
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1110260814000933
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author Ayman K.M. Hassan
Hosam Hasan-Ali
Salwa R. Demetry
Randa Refaat
Ahmed S. Ali
author_facet Ayman K.M. Hassan
Hosam Hasan-Ali
Salwa R. Demetry
Randa Refaat
Ahmed S. Ali
author_sort Ayman K.M. Hassan
collection DOAJ
description Objective: This study was performed to evaluate the feasibility and safety of early sheath removal after percutaneous coronary intervention (PCI) using a locally designed Assiut Femoral Compression Device (AFCD2) vs. manual compression (MC). Background: Due to antithrombotic therapy before, during, and after PCI, the arterial femoral sheath is generally not removed early after PCI. Patients and methods: This was a randomized, controlled trial. We enrolled all patients undergoing PCI at Assiut University Hospitals from September, 2013 to December, 2013. At the end of PCI, the arterial hemostasis method was randomly assigned 1:1 to AFCD2 vs. MC. The sheaths were removed 2 h after PCI, instead of conventional 6 h, in the AFCD2 arm. Results: The trial assigned 100 patients (mean age 57 ± 9 years, 75% men) to AFCD2 (n = 50) vs. MC (n = 50). Both groups were comparable regarding baseline characteristics. Concerning the primary effectiveness end point, there was significantly shorter mean time-to-ambulation with AFCD2 (8.2 ± 1.42 h) vs. MC (12.02 ± 0.22 h; p = <0.001). This was directly reflected on shorter time for hospital discharge eligibility in AFCD2 (11 ± 1 h) vs. MC (15 ± 1 h; p = <0.001). As regards safety, none of our research population experienced major adverse events. The use of AFCD2 was associated with similar occurrence of minor complications, mainly ecchymosis and oozing, compared with MC. Conclusion: Our results indicate that AFCD2 is a simple and effective alternative to MC for hemostasis following PCI. Early sheath removal 2 h post PCI is feasible, safe, and improves the patient’s comfort.
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spelling doaj.art-47f34e0732b04c90b7e21950aaa392612022-12-21T18:38:36ZengSpringerOpenThe Egyptian Heart Journal1110-26082015-03-01671697710.1016/j.ehj.2014.10.003Early sheath removal after percutaneous coronary intervention using Assiut Femoral Compression Device is feasible and safe. Results of a randomized controlled trialAyman K.M. Hassan0Hosam Hasan-Ali1Salwa R. Demetry2Randa Refaat3Ahmed S. Ali4Department of Cardiology, Faculty of Medicine, Assiut University, EgyptDepartment of Cardiology, Faculty of Medicine, Assiut University, EgyptDepartment of Cardiology, Faculty of Medicine, Assiut University, EgyptDepartment of Cardiology, Faculty of Medicine, Assiut University, EgyptDepartment of Mechanical Engineering, Mechatronics Division, Faculty of Engineering, Assiut University, EgyptObjective: This study was performed to evaluate the feasibility and safety of early sheath removal after percutaneous coronary intervention (PCI) using a locally designed Assiut Femoral Compression Device (AFCD2) vs. manual compression (MC). Background: Due to antithrombotic therapy before, during, and after PCI, the arterial femoral sheath is generally not removed early after PCI. Patients and methods: This was a randomized, controlled trial. We enrolled all patients undergoing PCI at Assiut University Hospitals from September, 2013 to December, 2013. At the end of PCI, the arterial hemostasis method was randomly assigned 1:1 to AFCD2 vs. MC. The sheaths were removed 2 h after PCI, instead of conventional 6 h, in the AFCD2 arm. Results: The trial assigned 100 patients (mean age 57 ± 9 years, 75% men) to AFCD2 (n = 50) vs. MC (n = 50). Both groups were comparable regarding baseline characteristics. Concerning the primary effectiveness end point, there was significantly shorter mean time-to-ambulation with AFCD2 (8.2 ± 1.42 h) vs. MC (12.02 ± 0.22 h; p = <0.001). This was directly reflected on shorter time for hospital discharge eligibility in AFCD2 (11 ± 1 h) vs. MC (15 ± 1 h; p = <0.001). As regards safety, none of our research population experienced major adverse events. The use of AFCD2 was associated with similar occurrence of minor complications, mainly ecchymosis and oozing, compared with MC. Conclusion: Our results indicate that AFCD2 is a simple and effective alternative to MC for hemostasis following PCI. Early sheath removal 2 h post PCI is feasible, safe, and improves the patient’s comfort.http://www.sciencedirect.com/science/article/pii/S1110260814000933Femoral Compression DevicePercutaneous coronary interventionHemostasisVascular complications
spellingShingle Ayman K.M. Hassan
Hosam Hasan-Ali
Salwa R. Demetry
Randa Refaat
Ahmed S. Ali
Early sheath removal after percutaneous coronary intervention using Assiut Femoral Compression Device is feasible and safe. Results of a randomized controlled trial
The Egyptian Heart Journal
Femoral Compression Device
Percutaneous coronary intervention
Hemostasis
Vascular complications
title Early sheath removal after percutaneous coronary intervention using Assiut Femoral Compression Device is feasible and safe. Results of a randomized controlled trial
title_full Early sheath removal after percutaneous coronary intervention using Assiut Femoral Compression Device is feasible and safe. Results of a randomized controlled trial
title_fullStr Early sheath removal after percutaneous coronary intervention using Assiut Femoral Compression Device is feasible and safe. Results of a randomized controlled trial
title_full_unstemmed Early sheath removal after percutaneous coronary intervention using Assiut Femoral Compression Device is feasible and safe. Results of a randomized controlled trial
title_short Early sheath removal after percutaneous coronary intervention using Assiut Femoral Compression Device is feasible and safe. Results of a randomized controlled trial
title_sort early sheath removal after percutaneous coronary intervention using assiut femoral compression device is feasible and safe results of a randomized controlled trial
topic Femoral Compression Device
Percutaneous coronary intervention
Hemostasis
Vascular complications
url http://www.sciencedirect.com/science/article/pii/S1110260814000933
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