Sheath pulling immediately after PTCA: comparison of two different deployment techniques for the hemostatic puncture...

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Access Management

Background:

• Immediate sheath removal post-percutaneous transluminal coronary angioplasty (PTCA) enhances patient comfort and reduces hospital stay.
• Hemostatic devices enable safe sheath removal in anticoagulated patients with low bleeding risk.
• Limited data exists on hemostatic puncture closing devices (HPCDs) for immediate sheath removal post-PTCA, especially concerning reduced deployment times.

Purpose of the Study:

• To evaluate the safety and efficacy of immediate sheath removal using an HPCD after PTCA.
• To determine if a reduced deployment time (DT) of 5 minutes is as effective as the standard 30 minutes.
• To assess the impact of reduced DT on bleeding complications and patient outcomes.

Main Methods:

• A prospective study randomized 140 patients undergoing PTCA to either a 5-minute or 30-minute HPCD deployment time.
• Key parameters monitored included hemostasis achievement, hematoma size at 24 hours, and occurrence of bleeding complications.
• Patient demographics and cardiovascular risk factors were comparable between the two groups.

Main Results:

• Immediate and complete hemostasis was achieved in 74% of the 5-minute DT group and 71% of the 30-minute DT group.
• No statistically significant differences were observed in hematoma size between the groups (6.2 cm² vs. 6.8 cm²).
• No severe bleeding or major vascular complications occurred in either the 5-minute or 30-minute deployment time groups.

Conclusions:

• The HPCD is effective and safe for immediate sheath removal post-PTCA.
• Reducing the HPCD deployment time from 30 to 5 minutes is safe and does not increase bleeding risks.
• Shorter deployment times facilitate faster patient transfer, reduce staff burden, and improve patient comfort.