Kardiologie

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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.