Immediate ambulation following diagnostic coronary angiography procedures utilizing a vascular closure device (The Closer™)

Christopher H. Crocker, Kevin T. Cragun, Farris K. Timimi, Robert J. Houlihan, Malcolm R. Bell, Ryan J. Lennon, Kirk N. Garratt, David Holmes, Henry H. Ting

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objective. We investigated the safety and efficacy of The Closer™, a suture-mediated vascular closure device, to facilitate immediate ambulation after diagnostic coronary angiography. Methods and Results. We identified 487 non-consecutive patients who were eligible for an immediate ambulation protocol following vascular closure after diagnostic coronary angiography. A total of 434 patients (89%) were allowed immediate ambulation (mean time, 6.3 ± 2.4 minutes) and 34 patients (7%) were treated with intermediate duration bed rest (mean time, 105.2 ± 55.3 minutes). Of the 34 patients treated with intermediate duration bed rest, ten had minor bleeding from the arterial access tract requiring 2-5 minutes of light compression and 24 were delayed secondary to physician preference. Nineteen patients (4%) failed to achieve hemostasis with The Closer™. Outpatients were followed up at 24 hours, and inpatients were followed up the next morning. Four patients (0.8%) suffered recurrent femoral artery bleeds after initially successful vascular closure. Three recurrent bleeds occurred during the observation period in-hospital and one occurred 6 days after device deployment. At follow-up, no patients developed the following: hematoma > 4 cm, ipsilateral retroperitoneal bleed, arterio-venous fistula, pseudoaneurysm, access site infection or loss of distal pulses. No patients had lower extremity ischemia or required blood transfusion. Conclusion. Use of The Close™ after diagnostic angiography with subsequent immediate ambulation is safe and effective for most patients. Overall, hemostasis was achieved in 96% of patients, with 89% of our patients able to ambulate immediately and 7% able to ambulate after intermediate duration bed rest.

Original languageEnglish (US)
Pages (from-to)728-732
Number of pages5
JournalJournal of Invasive Cardiology
Volume14
Issue number12
StatePublished - Dec 2002

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Coronary Angiography
Walking
Bed Rest
Hemostasis
Blood Vessels
Vascular Closure Devices
False Aneurysm
Femoral Artery
Blood Transfusion
Hematoma
Sutures
Fistula
Inpatients
Lower Extremity
Angiography
Outpatients
Ischemia
Observation
Hemorrhage
Physicians

Keywords

  • 6 French
  • Cardiac catheterization
  • Hemostasis
  • Percutaneous closure device
  • Vascular complications

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Crocker, C. H., Cragun, K. T., Timimi, F. K., Houlihan, R. J., Bell, M. R., Lennon, R. J., ... Ting, H. H. (2002). Immediate ambulation following diagnostic coronary angiography procedures utilizing a vascular closure device (The Closer™). Journal of Invasive Cardiology, 14(12), 728-732.

Immediate ambulation following diagnostic coronary angiography procedures utilizing a vascular closure device (The Closer™). / Crocker, Christopher H.; Cragun, Kevin T.; Timimi, Farris K.; Houlihan, Robert J.; Bell, Malcolm R.; Lennon, Ryan J.; Garratt, Kirk N.; Holmes, David; Ting, Henry H.

In: Journal of Invasive Cardiology, Vol. 14, No. 12, 12.2002, p. 728-732.

Research output: Contribution to journalArticle

Crocker, CH, Cragun, KT, Timimi, FK, Houlihan, RJ, Bell, MR, Lennon, RJ, Garratt, KN, Holmes, D & Ting, HH 2002, 'Immediate ambulation following diagnostic coronary angiography procedures utilizing a vascular closure device (The Closer™)', Journal of Invasive Cardiology, vol. 14, no. 12, pp. 728-732.
Crocker, Christopher H. ; Cragun, Kevin T. ; Timimi, Farris K. ; Houlihan, Robert J. ; Bell, Malcolm R. ; Lennon, Ryan J. ; Garratt, Kirk N. ; Holmes, David ; Ting, Henry H. / Immediate ambulation following diagnostic coronary angiography procedures utilizing a vascular closure device (The Closer™). In: Journal of Invasive Cardiology. 2002 ; Vol. 14, No. 12. pp. 728-732.
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abstract = "Objective. We investigated the safety and efficacy of The Closer™, a suture-mediated vascular closure device, to facilitate immediate ambulation after diagnostic coronary angiography. Methods and Results. We identified 487 non-consecutive patients who were eligible for an immediate ambulation protocol following vascular closure after diagnostic coronary angiography. A total of 434 patients (89{\%}) were allowed immediate ambulation (mean time, 6.3 ± 2.4 minutes) and 34 patients (7{\%}) were treated with intermediate duration bed rest (mean time, 105.2 ± 55.3 minutes). Of the 34 patients treated with intermediate duration bed rest, ten had minor bleeding from the arterial access tract requiring 2-5 minutes of light compression and 24 were delayed secondary to physician preference. Nineteen patients (4{\%}) failed to achieve hemostasis with The Closer™. Outpatients were followed up at 24 hours, and inpatients were followed up the next morning. Four patients (0.8{\%}) suffered recurrent femoral artery bleeds after initially successful vascular closure. Three recurrent bleeds occurred during the observation period in-hospital and one occurred 6 days after device deployment. At follow-up, no patients developed the following: hematoma > 4 cm, ipsilateral retroperitoneal bleed, arterio-venous fistula, pseudoaneurysm, access site infection or loss of distal pulses. No patients had lower extremity ischemia or required blood transfusion. Conclusion. Use of The Close™ after diagnostic angiography with subsequent immediate ambulation is safe and effective for most patients. Overall, hemostasis was achieved in 96{\%} of patients, with 89{\%} of our patients able to ambulate immediately and 7{\%} able to ambulate after intermediate duration bed rest.",
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AU - Cragun, Kevin T.

AU - Timimi, Farris K.

AU - Houlihan, Robert J.

AU - Bell, Malcolm R.

AU - Lennon, Ryan J.

AU - Garratt, Kirk N.

AU - Holmes, David

AU - Ting, Henry H.

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N2 - Objective. We investigated the safety and efficacy of The Closer™, a suture-mediated vascular closure device, to facilitate immediate ambulation after diagnostic coronary angiography. Methods and Results. We identified 487 non-consecutive patients who were eligible for an immediate ambulation protocol following vascular closure after diagnostic coronary angiography. A total of 434 patients (89%) were allowed immediate ambulation (mean time, 6.3 ± 2.4 minutes) and 34 patients (7%) were treated with intermediate duration bed rest (mean time, 105.2 ± 55.3 minutes). Of the 34 patients treated with intermediate duration bed rest, ten had minor bleeding from the arterial access tract requiring 2-5 minutes of light compression and 24 were delayed secondary to physician preference. Nineteen patients (4%) failed to achieve hemostasis with The Closer™. Outpatients were followed up at 24 hours, and inpatients were followed up the next morning. Four patients (0.8%) suffered recurrent femoral artery bleeds after initially successful vascular closure. Three recurrent bleeds occurred during the observation period in-hospital and one occurred 6 days after device deployment. At follow-up, no patients developed the following: hematoma > 4 cm, ipsilateral retroperitoneal bleed, arterio-venous fistula, pseudoaneurysm, access site infection or loss of distal pulses. No patients had lower extremity ischemia or required blood transfusion. Conclusion. Use of The Close™ after diagnostic angiography with subsequent immediate ambulation is safe and effective for most patients. Overall, hemostasis was achieved in 96% of patients, with 89% of our patients able to ambulate immediately and 7% able to ambulate after intermediate duration bed rest.

AB - Objective. We investigated the safety and efficacy of The Closer™, a suture-mediated vascular closure device, to facilitate immediate ambulation after diagnostic coronary angiography. Methods and Results. We identified 487 non-consecutive patients who were eligible for an immediate ambulation protocol following vascular closure after diagnostic coronary angiography. A total of 434 patients (89%) were allowed immediate ambulation (mean time, 6.3 ± 2.4 minutes) and 34 patients (7%) were treated with intermediate duration bed rest (mean time, 105.2 ± 55.3 minutes). Of the 34 patients treated with intermediate duration bed rest, ten had minor bleeding from the arterial access tract requiring 2-5 minutes of light compression and 24 were delayed secondary to physician preference. Nineteen patients (4%) failed to achieve hemostasis with The Closer™. Outpatients were followed up at 24 hours, and inpatients were followed up the next morning. Four patients (0.8%) suffered recurrent femoral artery bleeds after initially successful vascular closure. Three recurrent bleeds occurred during the observation period in-hospital and one occurred 6 days after device deployment. At follow-up, no patients developed the following: hematoma > 4 cm, ipsilateral retroperitoneal bleed, arterio-venous fistula, pseudoaneurysm, access site infection or loss of distal pulses. No patients had lower extremity ischemia or required blood transfusion. Conclusion. Use of The Close™ after diagnostic angiography with subsequent immediate ambulation is safe and effective for most patients. Overall, hemostasis was achieved in 96% of patients, with 89% of our patients able to ambulate immediately and 7% able to ambulate after intermediate duration bed rest.

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