Manual versus Mechanical Compression for Femoral Artery Hemostasis after Coronary Catheterization

Abstract

Vascular access site complications (VASCs) related to femoral artery remain an important source of increased morbidity, mortality, length of stay and cost. Incidence of VASCs post diagnostic CA includes: hematoma, retroperitoneal hematoma, arterial venous fistula, pseudo-aneurysms, acute limb ischemia/acute arterial thrombosis. This incidence of complications increases with PCI, as it requires potent use of oral and intravenous antiplatelet and anti-thrombin medications which increase the effectiveness of PCI, but it is also accompanying with an increased risk of VASCs (Gurzu & Jung, 2017). There are three methods are employed to achieve femoral artery hemostasis following sheath removal after cardiac catheterization, they are the manual compression, mechanical compression and vascular closure devices. Manual compression has been the gold standard for obtaining hemostasis at the vascular access site for years, but this standard has changed as new devices have come on the market (Goswami et al., 2016). Manual compression for some practitioners is not an option because it requires strength and the ability to hold a good compression for 15 to 20 minutes and if hand and arm fatigue develops during the procedure, the amount of pressure applied to the femoral artery may vary causing