Safety of early ambulation after diagnostic and therapeutic neuroendovascular procedures without use of closure devices.
OBJECTIVE
To evaluate the safety of manual compression and early ambulation after diagnostic and therapeutic neuroendovascular procedures.


METHODS
Data were prospectively collected and retrospectively analyzed for consecutive patients undergoing diagnostic or therapeutic neuroendovascular procedures. Manual compression at the femoral access site was applied. The target for early ambulation was 2 hours after compression.


RESULTS
Three hundred forty-three patients were enrolled, of whom 295 were eligible for early ambulation. Diagnostic procedures totaled 214 (72.5%); therapeutic procedures, 81 (27.5%). Ambulation occurred at 2 hours for 82 patients who underwent a diagnostic and 11 patients who underwent a therapeutic procedure. Overall, 142 patients (66.4%) after a diagnostic and 21 patients (25.9%) after a therapeutic procedure ambulated within 3 hours; 94% of outpatients ambulated within 2 to 3 hours and were dismissed shortly thereafter. Delayed ambulation was related to nursing staff delays, recovery from general anesthesia, or patient preference. Fourteen patients (4.7%)--9 (4.2%) who had a diagnostic and 5 (6.2%) who had a therapeutic procedure--required delayed ambulation because of local oozing (8 patients), a hematoma of less than 5 cm (3 patients), a pseudoaneurysm (2 patients), or a large hematoma requiring surgical evacuation (1 patient).


CONCLUSIONS
Early ambulation is feasible and safe after diagnostic and therapeutic procedures and manual compression. A longer period of bed rest or the routine use of closure devices is often not required; thereby avoiding the costs associated with bed rest and the complications associated with closure devices.
Wagenbach
Anne
A
Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.
Saladino
Andrea
A
Daugherty
Wilson P
WP
Cloft
Harry J
HJ
Kallmes
David F
DF
Lanzino
Giuseppe
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001927:Brain Diseases / Q000175:diagnosis / Q000601:surgery; D017023:Coronary Angiography / Q000009:adverse effects*; D004434:Early Ambulation / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014696:Ventriculostomy / Q000009:adverse effects* / Q000295:instrumentation*; D055815:Young Adult