We report the safety and efficacy of sealing the femoral puncture site with percutaneously applied collagen after Palmaz-Schatz stent implantation in 100 consecutive patients. Patients were anticoagulated with continuous heparin infusion, overlapping oral anticoagulants, and antiplatelet therapy by dextran, aspirin, and dipyridamole. At the time of sheath removal and collagen application, the mean activated partial thromboplastin time and prothrombin time values expressed as international normalized ratio were 3.2 +/- 2.1 and 1.6 +/- 0.7, respectively. The hemostasis time ranged from 1 to 8 minutes (mean 2.18 +/- 2.08 minutes). Only two (2%) patients had major puncture-site bleeding (not seal related in one case) that required surgery and blood transfusions. Small (< 6 cm) and medium (6 to 10 cm) hematomas observed in 12 (12%) and 2 (2%) patients, respectively, resolved spontaneously without sequelae. Local infection developed in 2 (2%) patients, who were successfully treated with antibiotics without clinical consequences. Subacute stent thrombosis was observed in only 1 (1%) patient. Repeat catheterization through the same femoral artery was performed at 6-month follow-up in 55 patients without difficulty or vascular complications. These findings suggest that percutaneous collagen application after coronary stenting is a secure method of achieving prompt and effective femoral hemostasis with a low incidence of major vascular bleeding complications despite intense anticoagulation. Stable hemostasis may allow continued full-dose anticoagulation, reducing the risk of stent subacute thrombosis.
Prompt and safe femoral hemostasis with a collagen device after intracoronary implantation of Palmaz-Schatz stents / A.L.G. Bartorelli, P. Sganzerla, F. Fabbiocchi, P. Montorsi, N. De Cesare, M. Child, E. Tavasci, B. Passaretti, A. Loaldi. - In: AMERICAN HEART JOURNAL. - ISSN 0002-8703. - 130:1(1995 Jul), pp. 26-32-32.
|Titolo:||Prompt and safe femoral hemostasis with a collagen device after intracoronary implantation of Palmaz-Schatz stents|
BARTORELLI, ANTONIO LUCA GUIDO (Primo)
|Parole Chiave:||Drug Delivery Systems; Administration, Cutaneous; Analysis of Variance; Anticoagulants; Humans; Safety; Femoral Artery; Aged; Catheterization, Peripheral; Angioplasty, Balloon, Coronary; Femoral Vein; Collagen; Evaluation Studies as Topic; Prospective Studies; Hemostatic Techniques; Middle Aged; Stents; Male; Female|
|Settore Scientifico Disciplinare:||Settore MED/11 - Malattie dell'Apparato Cardiovascolare|
|Data di pubblicazione:||lug-1995|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/0002-8703(95)90231-7|
|Appare nelle tipologie:||01 - Articolo su periodico|