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42nd Annual Scientific Session of the American College of Cardiology, Anaheim, California, 1993
Early ambulation (30 minutes) after cardiac catheterization using the collagen plug. Efficacy and follow-up comparing two different dosages in 660 cases.
Silber S, Haentsch C, Seidel N, Mühling H
Dr. Müller Hospital, Munich, Germany
J Am Coll Cardiol, 21: 150A, (1993)
Outpatient cardiac catheterization (cath) using the femoral approach is usually performed with 5F sheaths and ambulation after appr. 4 hours. Purpose of this study was an investigate whether immediate hemostasis (hst) using a newly developed collagen plug may reduce the time to ambulation and to determine possible side effects.
660 consecutive outpatients were randomly assigned to either 2 plugs or 1 plug. Efficacy was graded as A (immediate hst), B (acceptable hst) and C (no hst). Pts with A and B were ambulated 30 minutes after plug. Follow up (next day, 1 and 4 weeks) included history, physical findings and duplex ultrasound of the puncture site. Results (% pf pts):
Immediate efficacy 2 plugs
1 plug
A 87 %
86 %
B 8 %
9 %
C 5 %
5 %
Follow up normal 70 %
88 %
little local swelling 27 %
12 %
severe local swelling 3 %
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No intravascular deployment, major bleeding complications or pseudoaneuryms occurred.
Conslusions: The collagen plug effectively allows ambulation 30 minutes after diagnostic cath in most patients. 1 plug is as safe as 2 plugs. Because of fewer side effects, 1 plug should be preferred.