title: Access site complications following transfemoral coronary procedures: comparison between traditional compression and angioseal vascular closure devices for haemostasis.
abstract: BACKGROUND
  Vascular closure devices such as angioseal are used as alternatives to traditional compression haemostasis. Although the safety and efficacy of angioseal are confirmed, their use remains controversial because of the potential complications of these devices compared with those of traditional compression haemostasis. The aim of this study was to compare the access site complication rate, the predictive factors for these complications, and patient comfort levels after coronary procedures with traditional compression or angioseal haemostasis.
  
  
  METHODS
  Data were collected from a cardiac unit in a medical center in northern Taiwan. A total of 130 adult patients were recruited and equally divided into two groups according to the method of haemostasis used after the coronary procedure: a traditional compression group and an angioseal group. We observed the incidence of access site complications, including bleeding, oozing, haematoma formation, and arteriovenous fistula formation. In addition, we used a 0-10 numeric rating scale to assess soreness, numbness, and back and groin access site pain after 1 h of catheter removal and immediately before getting out of bed.
  
  
  RESULTS
  The overall incidence of complications was 3.8 % (n = 5), which was not significantly different between the two groups (p = .06). The propensity score--adjusted multivariate analyses revealed that the only independent predictor for access site complications was an age of >70 years (OR, 10.44; 95 % CI, 1.81-60.06; p = .009). Comfort levels were higher in the angioseal group than in the traditional compression group.
  
  
  CONCLUSIONS
  Angioseal used after coronary procedures did not increase the incidence of complications relative to that associated with traditional compression haemostasis; however, it increased patient comfort levels. Health personnel should pay special attention to the predictive factor for access site complications after coronary procedures, such as age >70 years.
authors.affiliation: Department of Nursing, Taipei Veterans General Hospital, 201, Sec. 2, Shipai Road, Taipei City, 11217, Taiwan. r98426018@ntu.edu.tw.
authors.forename: Pei-Jung
authors.initials: PJ
authors.lastname: Wu
authors.affiliation: School of Nursing, College of Medicine, National Taiwan University, 1, Sec. 1, Jen-Ai Road, Taipei City, 10063, Taiwan. yutzu@ntu.edu.tw.
authors.forename: Yu-Tzu
authors.initials: YT
authors.lastname: Dai
authors.affiliation: Department of Internal Medicine, College of Medicine, National Taiwan University, 1, Sec. 1, Jen-Ai Road, Taipei City, 10063, Taiwan. hsienli_kao@yahoo.com.|Department of Internal Medicine, Division of Cardiology, National Taiwan University Hospital, 7, Chung Shan S. Rd., Taipei City, 10002, Taiwan. hsienli_kao@yahoo.com.
authors.forename: Hsien-Li
authors.initials: HL
authors.lastname: Kao
authors.affiliation: Department of Medicine Research, National Taiwan University Hospital, 7, Chung Shan S. Rd., Taipei City, 10002, Taiwan. chinhao@ntuh.gov.tw.
authors.forename: Chin-Hao
authors.initials: CH
authors.lastname: Chang
authors.affiliation: School of Nursing, College of Medicine, National Taiwan University, 1, Sec. 1, Jen-Ai Road, Taipei City, 10063, Taiwan. mfalou@ntu.edu.tw.
authors.forename: Meei-Fang
authors.initials: MF
authors.lastname: Lou
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000379:methods; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D058128:Compression Bandages; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006489:Hemostatic Techniques; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D013624:Taiwan; D065506:Vascular Closure Devices