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Outcomes of Same-Day Discharge with Manual Compression and 5F Sheath Compatible Devices for Lower Extremity Arterial

Yann Gouëffic1, Jean-Luc Pin2, Jean Sabatier3

  • 1Groupe Hospitalier Paris St Joseph, Service de Chirurgie Vasculaire et Endovasculaire, Paris, France.

Annals of Vascular Surgery
|November 15, 2021
PubMed

Insights

Manual compression is a safe and effective option for same-day discharge in patients undergoing lower extremity arterial disease (LEAD) endovascular procedures using a 5F sheath. This approach avoids arterial closure devices and demonstrates good clinical outcomes.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Endovascular Procedures

Background:

  • Lower extremity arterial disease (LEAD) management often involves endovascular revascularization.
  • Same-day discharge protocols aim to improve patient flow and reduce healthcare costs.
  • Arterial closure devices are commonly used for femoral access hemostasis.

Purpose of the Study:

  • To evaluate the safety and efficacy of manual compression for same-day discharge after 5F sheath endovascular LEAD revascularization.
  • To assess the in-hospital admission and 1-month rehospitalization rates.
  • To compare clinical and hemodynamic status post-procedure to baseline.

Main Methods:

  • Prospective, national, multicenter, single-arm study (FREEDOM OP).
  • Inclusion of symptomatic LEAD patients (Rutherford 2-5) eligible for same-day discharge.
  • Primary endpoint: total in-hospital admission rate (including overnight surveillance and 1-month rehospitalization).

Main Results:

  • 114 patients included; mean age 66±10 years; 94% claudicants.
  • 97% technical success for femoropopliteal lesions; 4.5% major access-related complications.
  • 11% total in-hospital admission rate; no deaths or major cardiovascular events; significant clinical and hemodynamic improvement.

Conclusions:

  • Manual compression is a feasible and safe hemostasis method for same-day discharge in LEAD endovascular procedures.
  • This technique offers a viable alternative to arterial closure devices.
  • Patients experience significant clinical and hemodynamic benefits post-procedure.
Abstract

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