title: Vascular access site complications with the use of closure devices in patients treated with platelet glycoprotein IIb/IIIa inhibitors during rescue angioplasty.
abstract: The objective of this study was to evaluate the effectiveness of two different closure devices in patients undergoing rescue percutaneous coronary intervention (PCI) using IIb/IIIa inhibitors and to compare it with patients undergoing elective PCI. One hundred sixty-two patients undergoing rescue PCI treated with IIb/IIIa inhibitors underwent vascular access site closure (6 Fr Perclose, n = 92, or 6 Fr Angioseal, n = 70). Vascular complications were compared with a sex- and age-matched group (n = 100) of patients undergoing manual compression after sheath removal and a similar group of patients undergoing elective PCI (n = 196). The incidence of access site complications was not significantly different between the three groups undergoing rescue PCI and was not higher than in patient receiving GP IIb/IIIa inhibitors without fibrinolysis (RR = 0.95; 95% CI = 0.88-1.01). In patients undergoing rescue PCI and receiving IIb/IIIa inhibitors, closure devices allow early sheath removal and are associated with similar outcomes compared with manual compression and elective PCI regardless of the type of closure device used.
authors.affiliation: Cardiology Division, University of Texas Medical School and Memorial Hermann Hospital, Houston, Texas 77030, USA.
authors.forename: Fernando
authors.initials: F
authors.lastname: Boccalandro
authors.forename: Abid
authors.initials: A
authors.lastname: Assali
authors.forename: Kenichi
authors.initials: K
authors.lastname: Fujise
authors.forename: Richard W
authors.initials: RW
authors.lastname: Smalling
authors.forename: Stefano
authors.initials: S
authors.lastname: Sdringola
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000209:etiology; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006406:Hematoma / Q000209:etiology; D006488:Hemostasis, Surgical; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010960:Plasminogen Activators / Q000627:therapeutic use; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors*; D019736:Prostheses and Implants; D011994:Recombinant Proteins / Q000627:therapeutic use; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
chemical_list: D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D011994:Recombinant Proteins; C087896:reteplase; D010960:Plasminogen Activators; D010959:Tissue Plasminogen Activator