[Strategy and results of pneumatic compression following transfemoral catheterization].
OBJECTIVE
Transfemoral arterial access of catheterization requires a method of hemostasis that is always easily and quickly applicable, but also safe, inexpensive and comfortable for the patient. Current methods meet these requirements only in part. The pneumatic pressure-controlled FemoStop system has been described as straightforward and safe. But the conventional procedure has been to achieve primary hemostasis with FemoStop and then switch to a pressure bandage. We here present our method of using FemoStop alone for the entire duration of the compression and compare the results with those of manual compression.


METHODS
The preferred methods of managing the arterial puncture site in our center were compared for two different periods. Group MC (manual compression) comprised 1,085 patients (mean age 63.310.5 years, 29.8% females) in whom manual compression had been applied followed by a pressure bandage. Group FS (pneumatic compression) comprised 1,087 consecutive patients (mean age 64.610.7%, 35.1% females) in whom pneumatic compression only had been applied. The incidence of pseudoaneurysms, a-v fistulas and bleeding requiring transfusion were compared.


RESULTS
The incidence of pseudoaneurysms after diagnostic cardiac catheterization in the FS group was lower than in the MC group. In patients after an angioplasty the results were similar other than the time the patient has to remain in bed. The incidence of a-v fistulas was similar in the two groups. There was only one episode pf bleeding that required transfusion (MC group). A multivariate analysis indicated that female gender is an independent risk factor for the occurrence of pseudoaneurysms and a-v fistulas.


CONCLUSIONS
The FemoStop system used by itself took less time than manual compression and was associated with a slightly lower risk of complications.
Weber
F
F
Frankenwaldklinik Kronach, Abteilung für Innere Medizin. frank.weber@frankenwaldklinik.de
Schneider
H
H
Weber
B
B
Nienaber
C A
CA
D017541:Aneurysm, False / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D001164:Arteriovenous Fistula / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D001458:Bandages; D001803:Blood Transfusion / Q000706:statistics & numerical data; D005260:Female; D006488:Hemostasis, Surgical / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D015994:Incidence; D048228:Intermittent Pneumatic Compression Devices / Q000592:standards*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019106:Postoperative Hemorrhage / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D011312:Pressure; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors