• Ann Vasc Surg · May 2010

    Early ambulation after percutaneous femoral access with use of closure devices and hemostatic agents.

    • Travis L Engelbert, Anjali Scholten, Kari Thompson, Adam Spivack, and Nikhil Kansal.
    • Veterans Administration San Diego Healthcare System, Section of Vascular and Endovascular Surgery, Department of Surgery, University of California, San Diego, San Diego, CA 92103, USA.
    • Ann Vasc Surg. 2010 May 1; 24 (4): 518-23.

    BackgroundPatient satisfaction after percutaneous endovascular procedures is significantly influenced by the amount of time to ambulation postprocedure. The purpose of this study was to assess the complication rates of early ambulation after use of closure devices or topical hemostatic agents for femoral access sites for endovascular procedures.MethodsA retrospective review was performed of all patients who underwent an endovascular procedure from a femoral access site between January 2004 and March 2008. The access site was closed with an Angio-Seal, StarClose, or D-Stat Dry with pressure. Patients ambulated 2 hr postprocedure when a closure device was used and 4 hr postprocedure when a D-Stat pad was applied. Access-site bleeding complications were assessed. Sheath size, closure method, patient characteristics, and antiplatelet status were analyzed.ResultsA total of 245 patients with a mean age of 70 years were identified. Of these, 154 (63%) patients were treated with a D-Stat pad with pressure, Angio-Seal was used on 83 (34%), and StarClose was used on eight (3%). The overall complication rate was 5.7%. Complications increased with increasing age (p = 0.003) and use of StarClose (p = 0.0001). The D-Stat pad was associated with a decreased complication rate (p = 0.03). Sheath size did not influence the incidence of bleeding. There was no significant increase in complications in patients taking an antiplatelet agent.ConclusionWith a protocol using closure devices and hemostatic agents, early ambulation after percutaneous femoral access can be achieved safely with an acceptable complication rate in patients with peripheral vascular disease.Copyright 2010 Annals of Vascular Surgery Inc. All rights reserved.

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