Complications in places of percutaneous coronary interventions: comparison of manual compression and clip application devices to achieve hemostasis

Abstract

Vascular closure devices, used for over 20 years as an alternative to manual compression to achieve hemostasis. Although the clinical effi cacy and safety of clip application devices type VCD have been confi rmed in several studies, their use remains controversial due to complications in the access by using these devices. The purpose of this study — comparing the frequency of formation of regional vascular complications , risk factors for these complications, hemostatic time, duration of immobilization, the period of stay in hospital and the patients comfort level after percutaneous coronary interventions (PCI) with the traditional manual hemostasis and using VCD. For a retrospective analysis of medical records were selected 246 adult patients from City Hospital of Moscow n.a. M.P. Konchalovskiy, SMRC in Moscow which was performed PCI. The main group, where hemostasis after endovascular procedures was achieved with the help of clip application device StarClose SE (Abbott Vascular), made up of 128 patients, control group — 118 patients with carrying out manual hemostasis. Evaluation of subjective sensations (pain, numbness, etc.) was carried out using a rating scale. The frequency of complications in the study group was 6.25% in the control group — 6.78%. The comfort level of patients was higher in the study group. The results showed that the use of StarClose device to achieve hemostasis after PCI does not increase the frequency of regional vascular complications compared with manual hemostasis. At the same time, the use of vascular closure devices is an eff ective way to reduce hemostasis time, can reduce the period of immobilization of the patient, which increases patient comfort and reduces the patient’s stay in the hospital.