Transluminal coronary angioplasty: Comparison of brachial and femoral artery methods

1983 ◽  
Vol 9 (6) ◽  
pp. 547-552 ◽  
Author(s):  
Gerald Dorros ◽  
Simon H. Stertzer Fsca ◽  
Richard K. Myler Fsca ◽  
Martin Kaltenbach ◽  
Donald A. Spring Fsca
Keyword(s):  
Femoral Artery ◽  
Coronary Angioplasty ◽  
Transluminal Coronary Angioplasty

Reducing time in bed after percutaneous transluminal coronary angioplasty (TIBS III)

2000 ◽  
Vol 9 (3) ◽  
pp. 185-187 ◽  
Author(s):  
AW Keeling ◽  
CA Fisher ◽  
KH Haugh ◽  
ER Powers ◽  
MS Turner
Keyword(s):  
Femoral Artery ◽  
Coronary Angioplasty ◽  
Medical Center ◽  
Percutaneous Transluminal Coronary Angioplasty ◽  
Control Group ◽  
Control Group Design ◽  
Time In Bed ◽  
Transluminal Coronary Angioplasty ◽  
Percutaneous Transluminal ◽  
Experimental Group

BACKGROUND: This study is the third in a series of investigations on the requisite length of time that patients should be restricted to bed after coronary arteriography or percutaneous transluminal coronary angioplasty using a femoral artery approach. METHODS: A prospective, experimental-control group design with randomization was used initially to compare the incidence of bleeding between patients who remained in bed for 4 hours and patients who remained in bed for 6 hours after sheath removal following percutaneous transluminal coronary angioplasty. RESULTS: Rapid changes in the healthcare environment led to nurses collecting complete data sets for the experimental group only. The experimental group (n = 51) was 73% male and 27% female; mean age was 57 years (SD = 11.4 years). Mean time in bed was 4.1 hours (SD = 0.27 hours). Most patients (98%) did not bleed from the femoral artery access site after remaining in bed for 4 hours following sheath removal. Ninety-two percent of patients required analgesics while in bed. Mean length of stay after the angioplasty was 1.4 days (SD = 0.79 days). Bleeding occurred in one subject and was related to multiple invasive procedures and an activated clotting time of greater than 200 seconds. CONCLUSIONS: Requisite time in bed after percutaneous transluminal coronary angioplasty has been reduced to 4 hours at the University of Virginia Medical Center, the same time required for patients undergoing cardiac catheterization. Discomfort after the procedure remains to be addressed.

Effects of 3 analgesic regimens on the perception of pain after removal of femoral artery sheaths

2000 ◽  
Vol 9 (2) ◽  
pp. 125-129 ◽  
Author(s):  
TR Fulton ◽  
GI Peet ◽  
MA McGrath ◽  
JD Hilton ◽  
RE Smith ◽  
...  
Keyword(s):  
Side Effects ◽  
Femoral Artery ◽  
Coronary Angioplasty ◽  
Percutaneous Transluminal Coronary Angioplasty ◽  
Rescue Analgesia ◽  
Intravenous Fentanyl ◽  
Pain Scores ◽  
Intravenous Morphine ◽  
Transluminal Coronary Angioplasty ◽  
Percutaneous Transluminal

BACKGROUND: Effective pain management after removal of femoral artery sheaths after percutaneous transluminal coronary angioplasty is highly individualized and requires frequent, accurate assessment and administration of analgesics as needed. OBJECTIVE: To determine which of 3 analgesic regimens is most effective in decreasing patients' perception of pain with the fewest side effects after removal of a femoral artery sheath. SAMPLE: 130 adult who had undergone percutaneous transluminal coronary angioplasty and were in an 8-bed cardiac short-stay unit in a 1400-bed acute care hospital. METHOD: Patients were randomized to receive either intravenous morphine, intravenous fentanyl, subcutaneous lidocaine around the sheath site, or an intravenous placebo before sheath removal. Rescue analgesia (intravenous fentanyl) was made available to all groups. Patients used a visual analog scale to assess pain within 10 minutes before, 1 minute after, and 20 minutes after sheath removal. Pain levels, frequency of side effects, and use of rescue analgesia were compared among groups. RESULTS: Age, sex, number of stents, and frequency of hematomas did not differ significantly among groups. Pain ratings, use of rescue analgesia, and side effects (nausea, vomiting, or vasovagal symptoms) were not significantly different among treatment groups. Ratings of pain were slightly higher immediately after sheath removal in all groups. CONCLUSION: For most patients, removal of femoral artery sheaths and manual compression for hemostasis are relatively pain-free. Pain scores among patients given analgesia with subcutaneous lidocaine, intravenous morphine, or intravenous fentanyl were not significantly different from pain scores among control patients.

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