Femoral arterial closure using ProGlide® is more efficacious and cost-effective when ambulating early following cardiac catheterization

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• 作者：Aravind Sekhar ; M.D. ; Ph.D.^a ; ^b ; Brad S. Sutton ; M.D. ; M.B.A.^a ; ^b ; Prafull Raheja ; M.D.^a ; ^b ; Amr Mohsen ; M.D.^a ; ^b ; Emily Anggelis ; B.S.^a ; ^b ; Chris N. Anggelis ; M.D.^a ; ^b ; Matthew C. Keith ; M.D. ; Ph.D.^a ; ^b ; Buddhadeb Dawn ; M.D.^c ; Samantha Straton ; R.N.^a ; ^b ; Michael P. Flaherty ; M.D. ; Ph.D.^a ; ^b ; ^{mpflah01@louisville.edu}
• 关键词：VCD ; vascular closure devices ; MC ; manual compression ; PD ; Perclose ProGlide device ; TTH ; time-to-hemostasis ; TTA ; time-to-ambulation ; TTD ; time-to-discharge
• 刊名：IJC Heart & Vasculature
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：13
• 期：Complete
• 页码：6-13
• 全文大小：497 K
• 卷排序：13

文摘

This was a prospective, single-center study evaluating the efficacy and cost-effectiveness of early ambulation (within 30 min) following femoral artery closure with the ProGlide® suture-mediated vascular closure device (PD) in patients undergoing diagnostic cardiac catheterization compared with manual compression.BackgroundIt is unclear whether early ambulation with ProGlide is safe or is associated with patient satisfaction and cost savings as compared with manual compression (MC).Methods and resultsInclusion criteria were met in 170 patients (85 PD and 85 MC patients). Patients ambulated 20 ft. within 30 min (PD) or after the requisite 4 h recumbent time (MC) if feasible. Primary endpoint was time-to-ambulation (TTA) following device closure. We also directly compared the safety of closure, times-to-hemostasis (TTH), -ambulation (TTA) and -discharge (TTD) with MC and, using a fully allocated cost model, performed cost analysis for both strategies. Multivariate analysis was used to determine predictors of patient satisfaction. The primary endpoint of safe, early ambulation was achieved following closure (mean of 27.1 ± 14.9 min; 95% confidence interval [CI] 25.2–30.2). Predictors of patient satisfaction in the PD group were absence of pain during closure, decreased TTA, and drastic reductions in TTD; the latter contributed indirectly to significant cost savings in the PD group (1250.3 ± 146.4 vs. 2248.1 ± 910.2 dollars, respectively; P < 0.001) and incremental cost savings by strategy also favored closure over MC ($84,807).ConclusionsProGlide is safe and effective for femoral artery closure in patients who ambulate within 30 min after cardiac catheterization; translating into improved patient satisfaction and substantial cost savings.