Access site management after peripheral percutaneous transluminal procedures: Neptune pad compared with conventional manual compression.
OBJECTIVE
To investigate the safety and efficacy of the procoagulant wound dressing Neptune Pad (Biotronik, Berlin, Germany) compared with those of conventional manual compression for access site management after peripheral percutaneous interventions.


METHODS
The study was approved by the institutional ethics committee, and all patients gave written informed consent. Two hundred one consecutive patients were enrolled and were randomly assigned to be treated with the Neptune Pad (n = 100) or conventional manual compression (n = 101). Patients were followed up clinically until hospital discharge and with duplex ultrasonography at 24 hours after the procedure to evaluate occurrence of access site complications. Time to hemostasis and time to ambulation were recorded, and patient and physician discomfort were measured by using a visual analogue scale.


RESULTS
The risk for access site complications was not significantly different between the Neptune Pad group and the conventional compression group (adjusted odds ratio, 1.15; 95% confidence interval: 0.47, 2.84; P = .76). Time to hemostasis was marginally reduced in the Neptune Pad group. Patient and physician discomfort were lessened with use of the device.


CONCLUSIONS
The hemostatic device Neptune Pad does not improve the safety of access site management after peripheral percutaneous procedures. Markedly improved comfort was noted among patients in the Neptune Pad group and by the physicians obtaining hemostasis.
Department of Internal Medicine II, Division of Angiology, Medical University Vienna, General Hospital, Waehringer Guertel 18-20, A-1090 Vienna, Austria. wolfgang.mlekusch@meduniwien.ac.at
Wolfgang
W
Mlekusch
Erich
E
Minar
Petra
P
Dick
Schila
S
Sabeti
Andrea
A
Bartok
Markus
M
Haumer
Michael
M
Bonelli
Laurenz
L
Vormittag
Renate
R
Koppensteiner
Martin
M
Schillinger
D000368:Aged; D000369:Aged, 80 and over; D000464:Alginates / Q000008:administration & dosage; D000800:Angioplasty, Balloon; D001458:Bandages; D005260:Female; D020723:Glucuronic Acid / Q000008:administration & dosage; D006489:Hemostatic Techniques / Q000295:instrumentation*; D006603:Hexuronic Acids / Q000008:administration & dosage; D006801:Humans; D008297:Male; D010361:Patients; D011312:Pressure; D014652:Vascular Diseases / Q000601:surgery
D000464:Alginates; D006603:Hexuronic Acids; D020723:Glucuronic Acid