Vascular complications of early (3h) vs standard (6h) ambulation post-cardiac catheterization or percutaneous coronary intervention from the femoral artery

Kobrossi, Semaan; Tamim, Hani; Dakik, Habib A.

doi:10.1016/j.ijcard.2014.07.137

Cited by 6 publications

(6 citation statements)

References 11 publications

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“…Patients who developed hemodynamic instability, defined as uncontrolled hypertension or hypotension, tachycardia or bradycardia, or desaturation from baseline, were also considered to have major bleeding. If no hemodynamic instability occurred, bleeding was considered minor 8 ; 3) Any of the following vascular complications requiring surgical correction: retroperitoneal bleeding, pseudoaneurysm, or development of arteriovenous fistula 9 . …”

Section: Methodsmentioning

confidence: 99%

“…3) Any of the following vascular complications requiring surgical correction: retroperitoneal bleeding, pseudoaneurysm, or development of arteriovenous fistula 9 .…”

Section: Methodsmentioning

confidence: 99%

“…The sample size calculation was based on the assumption that the proportion of events would not be higher in IG than in CG participants. Considering a negligible difference between the intervention and control group, a 2% rate of events, and a 20% attrition rate, the minimum sample size was estimated at 714 patients for an alpha level of 0.05 and 80% statistical power 9 . Overall, 48 participants (6.6%) were lost to follow-up, for a final sample size of 730.…”

Section: Methodsmentioning

confidence: 99%

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Reducing bed rest time from five to three hours does not increase complications after cardiac catheterization: the THREE CATH Trial

Matte

Hilário²,

Reich

et al. 2016

Rev. Latino-Am. Enfermagem

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Objective: to compare the incidence of vascular complications in patients undergoing transfemoral cardiac catheterization with a 6F introducer sheath followed by 3-hour versus 5-hour rest. Methods: randomized clinical trial. Subjects in the intervention group (IG) ambulated 3 hours after sheath removal, versus 5 hours in the control group (CG). All patients remained in the catheterization laboratory for 5 hours and were assessed hourly, and were contacted 24, 48, and 72 h after hospital discharge. Results: the sample comprised 367 patients in the IG and 363 in the GC. During cath lab stay, hematoma was the most common complication in both groups, occurring in 12 (3%) IG and 13 (4%) CG subjects (P=0.87). Bleeding occurred in 4 (1%) IG and 6 (2%) CG subjects (P=0.51), and vasovagal reaction in 5 (1.4%) IG and 4 (1.1%) CG subjects (P=0.75). At 24-h, 48-h, and 72-h bruising was the most commonly reported complication in both groups. None of the comparisons revealed any significant between-group differences. Conclusion: the results of this trial show that reducing bed rest time to 3 hours after elective cardiac catheterization is safe and does not increase complications as compared with a 5-hour rest. ClinicalTrials.gov Identifier: NCT-01740856

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Section: Methodsmentioning

confidence: 99%

“…3) Any of the following vascular complications requiring surgical correction: retroperitoneal bleeding, pseudoaneurysm, or development of arteriovenous fistula 9 .…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Reducing bed rest time from five to three hours does not increase complications after cardiac catheterization: the THREE CATH Trial

Matte

Hilário²,

Reich

et al. 2016

Rev. Latino-Am. Enfermagem

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show abstract

“…In descriptive studies, the most common complications found after coronary angiography were related to the access site, most commonly hematoma, followed by bleeding and pseudoaneurysm. 4,17,18 Researchers in 1 of these studies found no significant patient-related or practice-related characteristics associated with these complications. 4 However, in a much larger study of 1000 patients conducted in 2009, 2 characteristics of patients were found to be significantly associated with bleeding complications: elevated systolic blood pressure and female sex.…”

Section: Postangiography Bleeding Complicationsmentioning

confidence: 99%

Comparison of Head Elevation Protocols Following Femoral Artery Sheath Removal After Coronary Angiography

Olson

2016

Critical Care Nurse

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OBJECTIVES To compare 2 standard protocols for head elevation following removal of a femoral artery sheath after coronary angiography and their effects on bleeding complications and reported levels of back pain. One protocol involved flat supine bed rest; the other allowed progressive head elevation. METHODS A prospective comparative study of 80 adult patients undergoing coronary angiography via the femoral approach. The Numeric Rating Scale was used as the measure of reported pain. RESULTS No bleeding complications occurred in either group. Both groups had very low mean pain scores. Repeated-measures analysis demonstrated that the experience of pain differed significantly over time by location (F 5,70 = 3.864, P = .004), with a notable decrease in pain scores more than 1 hour after sheath removal at the location that used the progressive head elevation protocol. Patients' satisfaction scores after discharge did not differ significantly between the 2 groups. Patients with a history of chronic back pain had consistently higher pain scores, but those pain scores did not differ significantly by location (or protocol). CONCLUSIONS It appears that using a progressive head-elevation protocol within the first 3 hours after diagnostic angiography is not associated with an increased risk of bleeding complications at the access site and warrants further exploration in the mitigation of back pain associated with prolonged supine bed rest. (Critical Care Nurse. 2016;36[3]:20-35)

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“…Early mobilization protocols following cardiac catheterization for PCI have not been formally established or based on scientific evidence. Historically, patients who undergo catheterization via the femoral artery are managed more conservatively with periods of bed rest following sheath removal ranging from 2 to 24 hours following the procedure 53–55. However, a meta-analysis found that early mobility and ambulation 1.5 to 6 hours following PCI via femoral catheterization is generally accepted to be safe with minimal risk for bleeding complications or hematoma formation 54.…”

Section: Early Mobility Following Pcimentioning

confidence: 99%

Troponin Elevation Following Percutaneous Coronary Intervention in Acute Coronary Syndrome

Miner¹,

Parcetich²,

Smith³

2021

Journal of Acute Care Physical Therapy

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Background: Recent advances in revascularization procedures have improved survival rates for individuals with acute coronary syndrome (ACS). However, evidence to guide clinical decision-making for early mobility following percutaneous coronary intervention (PCI) is extremely limited. Purpose: The purpose of this clinical perspective and literature review is to provide context for the clinical interpretation of cardiac troponin (cTn) levels in individuals with ACS following revascularization via PCI and present an evidence-supported clinical decision-making algorithm to guide clinicians in the appropriate timing of initiation of early mobility for individuals with ACS. Methods: A literature review on cTn values is presented to guide the clinical interpretation of laboratory values for clinical decision-making. A comparison of consensus-based guidelines for early mobility is presented as the basis for proposing a novel algorithm for clinical decision-making in individuals with ACS following PCI. Conclusion:The clinical value and utility of postprocedural cTn levels in individuals with ACS following PCI is to help understand prognosis and mortality but does not provide sufficient information about the safety of initiating early mobility following PCI. Decisions for initiation of early mobility in this population using the proposed evidence-supported algorithm may help avoid unnecessary prolongation of bed rest.

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Vascular complications of early (3h) vs standard (6h) ambulation post-cardiac catheterization or percutaneous coronary intervention from the femoral artery

Cited by 6 publications

References 11 publications

Reducing bed rest time from five to three hours does not increase complications after cardiac catheterization: the THREE CATH Trial

Reducing bed rest time from five to three hours does not increase complications after cardiac catheterization: the THREE CATH Trial

Comparison of Head Elevation Protocols Following Femoral Artery Sheath Removal After Coronary Angiography

Troponin Elevation Following Percutaneous Coronary Intervention in Acute Coronary Syndrome

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