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Mechanical Compression
"A Randomized Trial of Vascular Hemostasis Techniques to Reduce Femoral Vascular Complications After Coronary Intervention"; This prospective, randomized study compared mechanical clamp compression with manual compression for achieving hemostasis following catheterization using the femoral approach. Incidence of complications was compared between the two approaches, using a "composite of ultrasound-defined femoral vascular complications" as primary endpoint. All 778 patients had both arterial and venous sheaths placed and heparin (10000 to 12000 IU) administered as IV bolus, with additional heparin added to maintain ACT>300 seconds during the interventional procedure. The study found that: "compared to manual compression, mechanical clamp hemostasis reduced the primary adverse end point by 63% (p=0.041)", and "utilization of a mechanical clamp rather than conventional hand pressure to attain vascular hemostasis significantly reduces ultrasound-defined femoral vascular pathology".
"Manual Versus Mechanical Compression for Femoral Artery Hemostasis After Cardiac Catheterization"; This study sought to determine if use of a mechanical clamp is as effective as standard manual pressure for post-catheterization hemostasis. A total of 720 patients undergoing diagnostic catheterization at two community hospitals were included. The data indicated only one significant difference between the two techniques: compression time was approximately two minutes longer for mechanical compression. The study found that, of 136 patients who had previous catheterizations, 95 (70%) stated an explicit preference for mechanical over manual compression, indicating that the clamp was more comfortable. The study concluded that "Mechanical compression is as effective as manual compression for femoral artery hemostasis after cardiac catheterization."
"Use of Compressive Leverage Apparatus Versus Manual Pressure in Achieving Hemostasis After Invasive Procedures"; "There were no differences between the two methods (mechanical clamp versus manual pressure) in regard to drop in Hb, need for transfusion, vascular surgical repair, and time required to return to normal activity. The clamp device was preferred by 61% of patients who had a previous manual hold."
'Ease of use and patient comfort'; "Our techs/nurses are pleased to avoid tired hands from discontinuing sheaths. Though we obviously do not leave the patient's bedside when a CompressAR is in place, the fact that our nurse/tech has "hands free" allows that person to chart, give medications and do the other tasks necessary in our laboratory …Good hemostasis is achieved with a minimum of effort and without the variable pressure that is unavoidable when the pressure is by hand. The benefits of comfort, consistent pressure and good outcome for the patient make the CompressAR a terrific option for sheath removal in our busy cath lab." [an error occurred while processing this directive] |
