Elsevier

Mayo Clinic Proceedings

Volume 81, Issue 12, December 2006, Pages 1537-1540
Mayo Clinic Proceedings

ORIGINAL ARTICLE
Ambulation 1 Hour After Diagnostic Cardiac Catheterization: A Prospective Study of 1009 Procedures

https://doi.org/10.4065/81.12.1537Get rights and content

OBJECTIVE

To study the safety of a protocol that allows ambulation 1 hour after diagnostic cardiac catheterization with a transfemoral approach using a 5F catheter system.

PATIENTS AND METHODS

A total of 1005 consecutive patients (1009 procedures) undergoing outpatient diagnostic cardiac catheterization with a transfemoral approach using a 5F catheter system at the Mayo Clinic in Rochester, Minn, were included in this study from January 1, 2004, to August 31, 2005. All patients underwent standard manual compression to achieve hemostasis and were ambulated after 1 hour of bed rest.

RESULTS

The mean age of the patients was 64.5 years, and 62% were male. Minor vascular complications occurred in 33 procedures (3.3%), including 14 hematomas (1.4%) less than 4 cm and 19 cases of rebleeding (1.9%) that required repeated manual compression. Only 1 patient (0.1%) had a hematoma greater than 4 cm. No patient had a major complication, such as surgical repair, red blood cell transfusion, retroperitoneal bleeding, formation of an arteriovenous fistula or pseudoaneurysm, arterial occlusion, or an infection.

CONCLUSIONS

Ambulation 1 hour after diagnostic cardiac catheterization with a transfemoral approach using a 5F catheter system is safe and associated with low rates of vascular complications. This strategy may improve patient comfort, reduce resource utilization, and be preferable to use of vascular closure devices.

Section snippets

PATIENTS AND METHODS

This study was approved by the Mayo Foundation Institutional Review Board. An early ambulation protocol approved by the Division of Cardiovascular Diseases Clinical Practice Committee was evaluated prospectively in a consecutive series of 1005 patients. This group underwent 1009 transfemoral diagnostic cardiac catheterizations in our outpatient cardiac catheterization facility with use of 5F sheaths from January 1, 2004, to August 31, 2005. An adjunctive intravenous heparin bolus (1000-2500

RESULTS

A total of 1050 consecutive diagnostic cardiac catheterization procedures were performed using this protocol during the study period. Forty-one patients who declined to make their medical records available for research were excluded from the study, resulting in a total of 1009 procedures in 1005 unique patients. In-hospital follow-up was complete for all 1009 eligible procedures. The demographic and clinical characteristics of this patient cohort are described in Table 2.

Procedural outcomes and

DISCUSSION

The major finding of the current study is that in a large cohort of 1009 outpatient diagnostic catheterization procedures using 5F vascular access, ambulation 1 hour after sheath removal was safe. Observed minor and major vascular complications rates with this protocol were low, 3.3% and 0.1%, respectively.

CONCLUSIONS

Ambulation 1 hour after outpatient diagnostic 5F cardiac catheterization can be safely performed, with low rates of complications. This approach to managing the access site could significantly improve patient comfort and resource use in this setting.

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