Comparison of Complications in Percutaneous Coronary Intervention Patients Mobilized at 3, 4, and 6 Hours After Femoral Arterial Sheath Removal

Abstract

The purpose of this research study was to explore groin complication rates of patients mobilized at 3, 4, and 6 hours after femoral arterial sheath removal following a percutaneous coronary intervention procedure. Participants were recruited from those undergoing coronary angioplasty and coronary stent placement at a large public hospital in Brisbane, Queensland. Participants were randomly allocated to the 3, 4, or 6 hourly mobilization group. After removal of the femoral arterial sheath and again the next day, participants' groins were assessed for evidence of complications including hemorrhage, hematoma formation, and pseudoaneurysm. The results showed that the length of bed rest after arterial sheath removal had no significant effect on bleeding (F 304 = 5.39, P = 0.21) or hematoma formation (F 304 = 0.258, P = 0.612) at the groin puncture site for participants who mobilized at either 3, 4, or 6 hours after percutaneous coronary intervention arterial sheath removal.

Safety of Mobilizing Hospitalized Adults

“…25 Another study compared complications following femoral arterial sheath removal after mobilization at 3, 4, and 6 hours and found no significant effects on bleeding at the groin puncture site among the 3 different mobilization lengths. 29 Several other studies found similar results, with no additional risk of complication rates for early ambulation. 19,20,23,27,28,30 Other studies of patients who underwent different types of cardiac procedures also suggested the feasibility and safety of early ambulation.…”

“…A study of patients after transfemoral angiography assessed the incidence of hematoma formation, pseudoaneurysm development, and other groin complications between patients who ambulated at either 3 or 6 hours after catheter or sheath removal and found no significant differences. 29 Dowling et al 24 also found no difference in hematoma formation among patients ambulated 3 hours after angiography. In a study by Miracapillo and colleagues, 26 there were no statistical differences in hematoma rates, lead displacement, or high-pacing thresholds between patients mobilized 3 hours after pacemaker implantation compared with those mobilized after 24 hours.…”

“…[19][20][21][22][23][24][25][26][27][28][29][30][31] Specifically, the safety of early ambulation after coronary catheterization procedures has received attention. These studies assessed the safety and efficacy of early ambulation compared with standard protocols, based on the presence of complications such as bleeding, hematoma, and pseudoaneurysm.…”

The Effect of Head of Bed Elevation on Patient Comfort After Angiography

“…A total of 136 patients were consented and preliminarily screened before their procedure. Immediately on conclusion of the procedure, the patient was screened for additional procedural exclusions, or termination criteria, including a radial access (11), multiple or bilateral sticks in the femoral artery (15), any visible blood on the dressing (7) or a hematoma (1) at the arterial access site, or transfer to the intensive care unit (4). Four procedures were cancelled after the initial consent was obtained.…”

The Effect of Ice-Bag Applied to Femoral Region of Individuals with Percutaneous Coronary Intervention on Local Vascular Complications and Low Back-Pain

“…Although it is advised that patients stay in bed for a long time after PCI performed via femoral route to prevent development of complications, McCabe et al [39] denote that this practice is not evidence-based but traditional. Recent studies indicate early mobilization does not affect complication development adversely, but rather increases patient comfort [5,10,11,40,41]. It is stated that extended bed rest in supine position is hard and discomforting for the patient [10,11,15,36].…”