Two hour ambulation after coronary angioplasty and stenting with 6 F guiding catheters and low dose heparin

Objective-To evaluate the feasibility and safety of ambulation of patients two hours after elective coronary angioplasty or stenting,or both. Methods-Coronary angioplasty and stenting were performed using 6 F guiding catheters by the femoral approach and a standard dose of heparin 5000 IU. T here were no angiographic exclusion criteria except for planned atherectomy . Patients given oral anticoagulants or heparin were not eligible. All pati ents were given aspirin. Patients who underwent stent implantation also rec eived ticlopidine 250 mg daily. The arterial sheath was removed immediately after the procedure. Haemostasis was achieved by manual compression and ma intained with an inguinal compression bandage. Early ambulation was attempt ed after two hours of supine bed rest following removal of the bandage. Main outcome measures-The incidence of bleeding at or during ambulation req uiring compression and additional bed rest, and puncture site complications documented 48 hours after the procedure. Results-300 of 359 consecutive eligible patients were included for two hour ambulation. Stent implantation was performed in 32% of the procedures. The mean (SD) time to haemostasis was 9.6 (3.2) minutes. Bleeding at ambulatio n occurred in five patients (1.7%), and nine patients (3.0%) reached the se condary end point of haematoma > 5 x 5 cm at 48 hour follow up. All were tr eated conservatively without further sequelae. There was no late bleeding o r vascular complications. Conclusion-Ambulation two hours after elective balloon angioplasty or stent implantation with 6 F guiding catheters by the femoral route and low dose: heparin is feasible and safe, with a low incidence of puncture site compli cations, This early ambulation protocol facilitates a short hospital stay.