Review of the Methods to Prevent Femoral Arteriotomy Complications and Contrast Nephropathy in Patients Undergoing Cardiac Catheterization

Abstract

In general in Turkey, only manual pressure is used to achieve initial hemostasis at the femoral insertion site, with a pressure dressing and sandbag added to maintain hemostasis. Arterial closure devices are rarely used. In general, after the procedure, patients are required to lie flat with, at most, a 15- to 30-degree elevation during bed rest. To prevent contrast nephropathy in patients at risk, intravenous saline solutions are started before the procedure and continued afterward. In other patients, only oral fluid replacement is used. Traditional approaches in the management of femoral artery insertion site continue, and practices used in the prevention of contrast nephropathy are similar to current practices.

Guidelines for Authors

“…However, the authors did state that many of the trials reviewed were of poor methodological quality. 9 This study supports the standing orders that are followed by our institution. A comparative study of closure devices and manual compression using a retrospective review of patients with VCs after coronary and peripheral angiography demonstrated no difference between device and manual compression VC incidence.…”

Strategies for Decreasing Vascular Complications in Diagnostic Cardiac Catheterization Patients

“…8 The results of a large descriptive study involving 29 universities that completed a questionnaire support the current recommendations of frequent vital signs and groin assessment, head of bed elevation less than 30-, and bedrest for 4 to 6 hours after sheath removal. 9 This study supports the standing orders that are followed by our institution. However, these may be different in other units using various vascular closure devices.…”

Subsample analysis of the Vascular Complications Risk Score at two public referral centers for interventional cardiology

“…Other studies conducted at international centers have investigated changes in patients' lifestyle after PCI, or alterations after intervention (25) , or simply patients' recognition of or perceptions about their modifiable cardiovascular risk factors (26) . Regarding the prevention of vascular complications, a group in Turkey sought to determine the approaches used for prevention of complications of femoral arteriotomy and contrast-induced nephropathy in patients undergoing cardiac catheterization (27) . Thirty-six university-affiliated hospitals were sent a questionnaire which addressed hemostasisrelated care and prevention of contrast use; 29 responded.…”

“…Thirty-six university-affiliated hospitals were sent a questionnaire which addressed hemostasisrelated care and prevention of contrast use; 29 responded. The authors found that manual compression followed by pressure dressing and sandbag placement were the most common methods used to achieve hemostasis, while for prevention of contrast-induced nephropathy, intravenous saline solution is given before and after the procedure (27) . A review study that included four randomized clinical trials sought to assess pain control after introducer sheath removal in patients undergoing PCI and determine if pain relief had any influence on complication rates (28) .…”