Early ambulation after diagnostic heart catheterization.
The general recommended strategy after arterial invasive procedures is a 4- to 6-hour bed rest that is associated with patient discomfort and increased medical costs. We hypothesized that mobilization of selected patients at the second hour would not increase vascular complications. Coronary angiography was performed through the femoral route via 6-Fr catheters. Homeostasis was achieved by manual compression and maintained with a compressive bandage. A total of 1,446 patients were ambulated at the second hour and 1,226 of them were discharged without complication. A total of 220 patients required further follow-up due to blood oozing; 154 patients were conventionally ambulated due to difficult arterial access, longer (>15 minutes) compression time, hematoma formation within 2 hours, or hypertensive state (blood pressure >180/100 mm Hg). Twenty-five (16%) of those patients developed minor bleeding after ambulation. No major bleeding or large hematoma was observed during in-hospital observation. Ecchymosis (10% [2-hour group] vs 21% [4-5 hour group]) and small hematomas (22% vs 9%) were the most frequent complications after discharge. Early mobilization of selected patients undergoing diagnostic heart catheterization through the femoral artery via 6-Fr catheters is safe and associated with acceptable bleeding complication rates.
Boztosun
Bilal
B
Kosuyolu Heart and Research Centre, Cardiology Department, Istanbul, Turkey.
Günes
Yilmaz
Y
Yildiz
Ahmet
A
Bulut
Mustafa
M
Saglam
Mustafa
M
Kargin
Ramazan
R
Kirma
Cevat
C
D000328:Adult; D000368:Aged; D001458:Bandages; D006328:Cardiac Catheterization / Q000009:adverse effects; D017023:Coronary Angiography / Q000009:adverse effects; D004434:Early Ambulation / Q000009:adverse effects; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery; D006331:Heart Diseases / Q000000981:diagnostic imaging*; D006406:Hematoma / Q000209:etiology; D006470:Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006489:Hemostatic Techniques; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure; D011677:Punctures / Q000009:adverse effects; D013997:Time Factors