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A poly-N-acetyl glucosamine hemostatic dressing for femoral artery access site hemostasis after percutaneous coronary intervention: a pilot study.
- Source :
-
The Journal of invasive cardiology [J Invasive Cardiol] 2010 Jan; Vol. 22 (1), pp. 35-9. - Publication Year :
- 2010
-
Abstract
- Background: Arterial puncture closure devices have improved time to hemostasis and ambulation after percutaneous coronary intervention (PCI) relative to traditional manual compression, though complication rates for both methods leave room for improvement. In a pilot registry, the authors evaluated a topical hemostatic dressing containing poly-N-acetyl glucosamine (p-GlcNAc) post PCI in fully anticoagulated patients.<br />Methods and Results: In 100 patients undergoing PCI via the common femoral artery in the short-stay unit, the p-GlcNAc hemostatic dressing was applied with 15 minutes of manual compression at arterial access sites after arterial sheath removal. Procedural antiplatelet and anticoagulation therapies were aspirin, clopidogrel and bivalirudin. Patients were observed during 2 hours of bed rest and attempted to ambulate 2 hours post hemostasis. Effectiveness was assessed based on times to hemostasis and ambulation. Data were stratified by time elapsed since bivalirudin bolus or discontinuation of infusion (30 minutes, > 30-60 minutes, > 60 minutes). Mean time to hemostasis was 15.5 minutes. Mean time from hemostasis to ambulation was 2.08 hours; 87% of patients ambulated at 2 hours. Sheaths were removed at a mean 40.38 minutes after discontinuing bivalirudin. Anticoagulation status (as assessed by time since discontinuation of bivalirudin) did not influence time to hemostasis or ambulation. There was a single major complication (pseudoaneurysm), two minor rebleeds requiring additional manual compression, and 1 hematoma > 5 cm.<br />Conclusions: This p-GlcNAc topical hemostatic dressing safely achieved hemostasis at arterial access sites and early ambulation, even with nearly immediate sheath removal after PCI with systemic anticoagulation using bivalirudin.
- Subjects :
- Acetylglucosamine administration & dosage
Acetylglucosamine adverse effects
Administration, Topical
Aged
Anticoagulants therapeutic use
Female
Hemostatics administration & dosage
Hemostatics adverse effects
Hirudins
Humans
Male
Peptide Fragments therapeutic use
Pilot Projects
Recombinant Proteins therapeutic use
Retrospective Studies
Thrombosis prevention & control
Time Factors
Walking
Acetylglucosamine therapeutic use
Angioplasty, Balloon, Coronary methods
Biological Dressings
Femoral Artery physiology
Hemostasis physiology
Hemostatics therapeutic use
Regional Blood Flow physiology
Subjects
Details
- Language :
- English
- ISSN :
- 1557-2501
- Volume :
- 22
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- The Journal of invasive cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 20048398