Comfort and bleeding after percutaneous transluminal coronary angioplasty: comparison of a flexible sheath and a standard sheath

Abstract

Patients often have discomfort, especially back pain, after percutaneous transluminal coronary angioplasty because they must stay relatively flat while the sheath remains in the femoral vessel after the procedure. Flexible sheaths are now available, allowing the head of the bed to be raised to 60 degrees during this period of bed rest. We assessed comfort and the frequency of bleeding in patients who had undergone percutaneous transluminal coronary angioplasty and compared the findings between patients with a flexible sheath and patients with a standard sheath. Patients were randomly assigned either a flexible sheath or a standard sheath during percutaneous transluminal coronary angioplasty. Patients' comfort was assessed by administering a comfort questionnaire at two intervals after the procedure, and the frequency of bleeding was determined by reviewing the patients' charts. One hundred seven patients completed the questionnaire. The patients with a flexible sheath showed a significantly higher level of comfort than the patients with a standard sheath 5 hours after the procedure. Patients with a flexible sheath also received less pain medication than did patients with a standard sheath. The frequency of bleeding was comparable in both groups. Results of this study support the use of a flexible sheath to increase patients' comfort after percutaneous transluminal coronary angioplasty without increasing the frequency of bleeding.