Comparison of pneumatic compression device and sand bag with respect to peripheral vascular complications in elective cardiac catheterization and percutaneous femoral artery interventions

Abstract

Objectives: After coronary angiography (CAG) and percutaneous coronary intervention (PCI), the classic sand bag method and compression devices are widely used for control of bleeding and prevention of vascular complications on the intervention site. The purpose of our study was to assess the major peripheral vascular complications and compare the sand bag and a pneumatic compression device ("Close Pad") in terms of major peripheral vascular complications occurring after CAG, and PCI.Study design: Between June 2011 and November 2011, a total of 434 patients who were admitted to the Department of Cardiology of Uludag University Faculty of Medicine were included in the study. 396 patients underwent coronary angiography and 38 patients, PCI. Sand bag, and Close Pad were applied in 209, and 225 patients, respectively. Bleeding requiring transfusion, hematomas larger than 10 cm(2), pseudoaneurysm, and arteriovenous (AV) fistula were defined as the major local complications. Logistic regression analysis were used to evaluate the data.Results: Major vascular complications occurred in 2% of diagnostic angiography and in 13.2% of PCIs (p=0.003). The major vascular complications were significantly higher with the Close Pad device compared with sand bag (5.3% vs. 0.5%, p=0.007). Smoking, PCI, Close Pad application, use of clopidogrel, and anticoagulants were observed to have increased risk for major local complications. In the logistic regression analysis, only smoking and Close Pad usage were evaluated as independent variables that increased the risk of major vascular complications (p<0.05).Conclusion: Close Pad usage increases risk of vascular complications when compared with the sand bag in patients undergoing cardiac catheterizations. Especially after PCI, patients who will use Close Pad should be selected carefully