Femoral Artery Haemostasis After Coronary Angioplasty With Moderate Dose Heparin

Early retraction of the arterial introducer facilitates patient management after coronary angioplasty. Closure systems permit rapid haemostasis, but are costly and do not avoid all serious vascular complications. Moderate doses of heparin, used often at the moment, could allow immediate retraction of the introducer with rapid and safe haemostasis by manual compression.Methods: we evaluated prospectively in 350 consecutive patients the safety and efficacy of immediate retraction of the 6F introducer after coronary angioplasty performed by the femoral route with a moderate dose of heparin (70 IU. kg(-1)). Only procedures during acute infarction or using abciximab electively were excluded.Results: retraction of the introducer was immediate in 340 patients (97%). The dose of heparin administered was 5300+/-800 IU and the compression time was 11+/-4 minutes. The activated clotting time at retraction of the introducer was 254+/-46 s. Six (1.7%) serious vascular complications (4 significant haematomas and 2 false aneurysms) were noted during the hospital phase. A single patient (0.6%) was transfused and no vascular surgical procedure was necessary. The average duration of stay after angioplasty was 2.6+/-2.2 days and 73% of patients left before 48 hours.Conclusion: immediate retraction, of the arterial introducer is possible with simple manual compression, after coronary angioplasty performed with a moderate dose of heparin.