COMPARISON OF VASCULAR CLOSURE DEVICES VERSUS MANUAL COMPRESSION IN TERMS OF POSTOPERATIVE COMPLICATIONS AMONG PATIENTS UNDERGOING CEREBRAL ANGIOGRAPHY: A HOSPITAL-BASED OBSERVATIONAL STUDY
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Date
2022-05-24
Authors
Duaa Ahmad Hussein Faraj
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Abstract
Background: Transfemoral cerebrospinal angiographies are commonly performed in different healthcare settings around the world. Vascular closure devices (VCDs) and mechanical compression (MC) approaches are used to achieve hemostasis.
Objectives: This study was conducted to assess and compare postinterventional complications occurring among patients who underwent transfemoral cerebral angiography when MC or a VCD (Angio-Seal VIP) were used.
Methodology: This was a retrospective cohort study in which patients who underwent cerebral angiography At An-Najah National University and for whom MC or a VCD (Angio-Seal VIP) were used. The clinical files and records of the patients were reviewed for data collection.
Results: A total of 166 patients were included. Of those, 89 had MC and 77 had Angio-Seal VIP. Patients in the MC group had significantly higher prothrombin time (p-value = 0.009), partial thromboplastin time (p-value < 0.001), and international normalized ratio (p-value < 0.001). Angio-Seal VIP was associated with significantly shorter time to hemostasis (p-value < 0.001), lidocaine use (p-value = 0.012), use of acetylsalicylic acid (p-value = 0.001), and use of tirofiban (p-value < 0.001). More patients in the MC group reported discomfort at discharge compared to patients in the Angio-Seal VIP group (p-value = 0.001), stayed significantly longer duration in the intensive care unit (ICU) (p-value < 0.001), in the hospital (p-value < 0.001), needed longer mechanical ventilation hours (p-value = 0.030), reported higher postinterventional pain (p-value = 0.011), and needed prolonged bed rest hours (p-value = 0.007).
Conclusions: Findings of this study indicated that Angio-Seal VIP was associated with less postinterventional complications compared to MC for patients undergoing transfemoral cerebral angiographies. Although both methods could be safe and effective in helping achieve hemostasis, Angio-Seal VIP could reduce postinterventional complications that can lead to longer mechanical ventilation hours, higher postinterventional pain, longer stays in the ICU, in hospital, longer bed rest, and higher patient discomfort at discharge.
Keywords: Catheterization, cerebral angiography, femoral artery, hemostasis, mechanical compression, vascular closure device.