title: Randomized comparison of rapid ambulation using radial, 4 French femoral access, or femoral access with AngioSeal closure.
abstract: Radial access and closure devices are associated with improved quality of life (QOL) after cardiac catheterization. Whether this is related to the access site or time to ambulation is unknown. Seventy-five patients undergoing cardiac catheterization were randomized to femoral 6 Fr with AngioSeal closure (F+C), femoral 4 Fr without closure, and radial (R) access. All patients were ambulated at 1 hr. QOL was measured utilizing visual analogue scales and Short Form-36 at baseline, 1 day, and 1 week. Time to ambulation and discharge were equivalent, as was postprocedure QOL. However, angiographic quality was lower in the 4 Fr group (P < 0.0001) and catheterization costs were higher in the F+C group (P < 0.0001). Ambulation 1 hr after catheterization can be accomplished utilizing radial, femoral 6 Fr with closure device, or femoral 4 Fr access with equivalent outcomes and QOL. However, this is achieved at a higher cost with a closure device, or lesser angiographic quality with 4 Fr catheters.
authors.affiliation: Division of Cardiology, Department of Medicine, Medical College of Ohio, Toledo, Ohio 43614, USA.
authors.forename: Bhagat K
authors.initials: BK
authors.lastname: Reddy
authors.forename: Pamela S
authors.initials: PS
authors.lastname: Brewster
authors.forename: Thomas
authors.initials: T
authors.lastname: Walsh
authors.forename: Mark W
authors.initials: MW
authors.lastname: Burket
authors.forename: William J
authors.initials: WJ
authors.lastname: Thomas
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Cooper
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D006328:Cardiac Catheterization / Q000191:economics / Q000295:instrumentation; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000628:therapy; D004434:Early Ambulation / Q000191:economics; D004867:Equipment Design / Q000191:economics; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000628:therapy; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology; D011788:Quality of Life; D017534:Radial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D018434:Sickness Impact Profile; D016896:Treatment Outcome