Two hour ambulation after coronary angioplasty and stenting with 6 F guiding catheters and low dose heparin.
OBJECTIVE
To evaluate the feasibility and safety of ambulation of patients two hours after elective coronary angioplasty or stenting, or both.


METHODS
Coronary angioplasty and stenting were performed using 6 F guiding catheters by the femoral approach and a standard dose of heparin 5000 IU. There were no angiographic exclusion criteria except for planned atherectomy. Patients given oral anticoagulants or heparin were not eligible. All patients were given aspirin. Patients who underwent stent implantation also received ticlopidine 250 mg daily. The arterial sheath was removed immediately after the procedure. Haemostasis was achieved by manual compression and maintained with an inguinal compression bandage. Early ambulation was attempted after two hours of supine bed rest following removal of the bandage.


METHODS
The incidence of bleeding at or during ambulation requiring compression and additional bed rest, and puncture site complications documented 48 hours after the procedure.


RESULTS
300 of 359 consecutive eligible patients were included for two hour ambulation. Stent implantation was performed in 32% of the procedures. The mean (SD) time to haemostasis was 9.6 (3.2) minutes. Bleeding at ambulation occurred in five patients (1.7%), and nine patients (3.0%) reached the secondary end point of haematoma > 5 x 5 cm at 48 hour follow up. All were treated conservatively without further sequelae. There was no late bleeding or vascular complications.


CONCLUSIONS
Ambulation two hours after elective balloon angioplasty or stent implantation with 6 F guiding catheters by the femoral route and low dose heparin is feasible and safe, with a low incidence of puncture site complications. This early ambulation protocol facilitates a short hospital stay.
Koch
K T
KT
Department of Cardiology, B2-136, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands.
Piek
J J
JJ
de Winter
R J
RJ
Mulder
K
K
Schotborgh
C E
CE
Tijssen
J G
JG
Lie
K I
KI
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D000925:Anticoagulants / Q000008:administration & dosage; D003327:Coronary Disease / Q000628:therapy*; D004334:Drug Administration Schedule; D004434:Early Ambulation; D005240:Feasibility Studies; D005260:Female; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage; D015607:Stents; D013997:Time Factors
D000925:Anticoagulants; D006493:Heparin