TY - JOUR
T1 - Comparison of manual compression and vascular hemostasis devices after coronary angiography or percutaneous coronary intervention through femoral artery access
T2 - A meta-analysis of randomized controlled trials
AU - Dahal, Khagendra
AU - Rijal, Jharendra
AU - Shahukhal, Ravi
AU - Sharma, Sharan
AU - Watti, Hussam
AU - Azrin, Michael
AU - Katikaneni, Pavan
AU - Jimenez, Enrique
AU - Tandon, Neeraj
AU - Modi, Kalgi
AU - Lee, Juyong
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2018/3
Y1 - 2018/3
N2 - Objectives: To compare the efficacy and safety of manual compression (MC) with vascular hemostasis devices (VHD) in patients undergoing coronary angiography (CA) or percutaneous coronary intervention (PCI) through femoral artery access. Introduction: The use of femoral artery access for coronary procedures may result in access-related complications, prolonged immobility and discomfort for the patients. MC results in longer time-to-hemostasis (TTH) and time-to-ambulation (TTA) compared to VHDs but its role in access-related complications remains unclear in patients undergoing coronary procedures. Methods: We searched MEDLINE, EMBASE, Cochrane CENTRAL and relevant references for English language randomized controlled trials (RCT) from inception through September 30, 2016. We performed the meta-analysis using random effects model. The outcomes were time-to-hemostasis, time-to-ambulation, major bleeding, large hematoma > 5 cm, pseudoaneurysm and other adverse events. Results: The electronic database search resulted in a total of 44 RCTs with a total of 18,802 patients for analysis. MC, compared to VHD resulted in longer TTH [mean difference (MD): 11.21 min; 95% confidence interval (CI) 8.13–14.29; P < 0.00001] and TTA [standardized mean difference: 1.2 (0.79–1.62); P < 0.00001] along with excess risk of hematoma > 5 cm formation [risk ratio (RR): 1.38 (1.15–1.67); P = 0.0008]. MC resulted in similar risk of major bleeding [1.01 (0.64–1.60); P = 0.95] pseudoaneurysm [0.99 (0.75–1.29); P = 0.92], infections [0.52 (0.25–1.10); P = 0.09], need of surgery [0.60 (0.29–1.22); P = 0.16), AV fistula [0.93 (0.68–1.27); P = 0.63] and ipsilateral leg ischemia [0.95 (0.57–1.60); P = 0.86] compared to VHD. Conclusion: Manual compression increase time-to-hemostasis, time-to-ambulation and risk of hematoma formation compared vascular hemostasis devices.
AB - Objectives: To compare the efficacy and safety of manual compression (MC) with vascular hemostasis devices (VHD) in patients undergoing coronary angiography (CA) or percutaneous coronary intervention (PCI) through femoral artery access. Introduction: The use of femoral artery access for coronary procedures may result in access-related complications, prolonged immobility and discomfort for the patients. MC results in longer time-to-hemostasis (TTH) and time-to-ambulation (TTA) compared to VHDs but its role in access-related complications remains unclear in patients undergoing coronary procedures. Methods: We searched MEDLINE, EMBASE, Cochrane CENTRAL and relevant references for English language randomized controlled trials (RCT) from inception through September 30, 2016. We performed the meta-analysis using random effects model. The outcomes were time-to-hemostasis, time-to-ambulation, major bleeding, large hematoma > 5 cm, pseudoaneurysm and other adverse events. Results: The electronic database search resulted in a total of 44 RCTs with a total of 18,802 patients for analysis. MC, compared to VHD resulted in longer TTH [mean difference (MD): 11.21 min; 95% confidence interval (CI) 8.13–14.29; P < 0.00001] and TTA [standardized mean difference: 1.2 (0.79–1.62); P < 0.00001] along with excess risk of hematoma > 5 cm formation [risk ratio (RR): 1.38 (1.15–1.67); P = 0.0008]. MC resulted in similar risk of major bleeding [1.01 (0.64–1.60); P = 0.95] pseudoaneurysm [0.99 (0.75–1.29); P = 0.92], infections [0.52 (0.25–1.10); P = 0.09], need of surgery [0.60 (0.29–1.22); P = 0.16), AV fistula [0.93 (0.68–1.27); P = 0.63] and ipsilateral leg ischemia [0.95 (0.57–1.60); P = 0.86] compared to VHD. Conclusion: Manual compression increase time-to-hemostasis, time-to-ambulation and risk of hematoma formation compared vascular hemostasis devices.
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U2 - 10.1016/j.carrev.2017.08.009
DO - 10.1016/j.carrev.2017.08.009
M3 - Article
C2 - 28941744
AN - SCOPUS:85029637749
VL - 19
SP - 151
EP - 162
JO - Cardiovascular Revascularization Medicine
JF - Cardiovascular Revascularization Medicine
SN - 1553-8389
IS - 2
ER -