Je. Nordrehaug et al., RANDOMIZED EVALUATION OF AN INFLATABLE FEMORAL-ARTERY COMPRESSION DEVICE AFTER CARDIAC-CATHETERIZATION, Journal of interventional cardiology, 9(5), 1996, pp. 381-387
Mechanical femoral artery compression devices have several limitations
. We compared a novel disposable belt-held pneumatic compression devic
e to manual compression alone in 213 patients randomized into two equa
l groups. Both were comparable for age, gender, current therapy with a
spirin (ASA) and warfarin, diameter of the arterial sheath, previous p
rocedures via the same artery, procedure duration, and blood pressure.
Manual compression time was 12 +/- 3 minutes. Pneumatic compression w
as reduced during 60 minutes. Patient discomfort was assessed as none
(82% vs 88%), mild (13% vs 8%), moderate (3% vs 4%), or severe (2% vs
0%) for the manual versus pneumatic group, respectively. Bleeding and
hematoma occurred in 7.5% of patients with no difference between the t
reatment groups. However, manual compression was significantly more ef
fective in the higher range of systolic blood pressure, and pneumatic
in the lower range, with a cut point of approximately 170 mmHg. Predic
tors for bleeding were systolic blood pressure and dose of ASA. Among
113 patients with systolic blood pressure < 160 mmHg and low dose (75
mg) or no ASA, only 1 patient (0.9%) experienced bleeding while 31% of
16 patients with both elevated systolic blood pressure and high dose
ASA (150-330 mg) bled. We conclude that pneumatic femoral artery compr
ession does not reduce bleeding and hematoma compared with manual comp
ression. The use of low dose (75 mg) or no ASA, as well as giving spec
ial attention to patients with elevated systolic blood pressure, may r
educe the risk of bleeding after cardiac catheterization.