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Using vascular closure devices following out-of-hospital cardiac arrest?

Christ M, von Auenmueller KI, Liebeton J, Grett M, Dierschke W, Noelke JP, Breker IM, Trappe HJ - Int J Med Sci (2015)

Bottom Line: VCDs were used in 26 patients (34.2%), and 48 patients (63.2%) were treated with MTH.While there were significantly more overall vascular complications in the group of patients treated with MTH (12.5% versus 0.0%; p=0.05), vascular complications were similar between patients with VCD or manual compression, regardless of whether or not they were treated with MTH.Therefore, our data suggest that the use of VCDs in victims from OHCA might be feasible and safe in patients treated with MTH as well, at least if the decision to use them is individually carefully determined.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology and Angiology, Marienhospital Herne, Ruhr - University Bochum, Germany.

ABSTRACT

Objectives and background: Despite a generally broad use of vascular closure devices (VCDs), it remains unclear whether they can also be used in victims from out-of-hospital cardiac arrest (OHCA) treated with mild therapeutic hypothermia (MTH).

Methods: All victims from OHCA who received immediate coronary angiography after OHCA between January 1(st) 2008 and December 31(st) 2013 were included in this study. The operator decided to either use a VCD (Angio-Seal™) or manual compression for femoral artery puncture. The decision to induce MTH was based on the clinical circumstances.

Results: 76 patients were included in this study, 46 (60.5%) men and 30 (39.5%) women with a mean age of 64.2 ± 12.8 years. VCDs were used in 26 patients (34.2%), and 48 patients (63.2%) were treated with MTH. While there were significantly more overall vascular complications in the group of patients treated with MTH (12.5% versus 0.0%; p=0.05), vascular complications were similar between patients with VCD or manual compression, regardless of whether or not they were treated with MTH.

Conclusion: In our study, the overall rate of vascular complications related to coronary angiography was higher in patients treated with mild therapeutic hypothermia, but was not affected by the application of a vascular closure device. Therefore, our data suggest that the use of VCDs in victims from OHCA might be feasible and safe in patients treated with MTH as well, at least if the decision to use them is individually carefully determined.

No MeSH data available.


Related in: MedlinePlus

Differences within the group of patients treated with vascular closure devices depending on whether they received mild therapeutic hypothermia (MTH) or not.
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Related In: Results  -  Collection


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Figure 1: Differences within the group of patients treated with vascular closure devices depending on whether they received mild therapeutic hypothermia (MTH) or not.

Mentions: In our study, VCDs were used in about one third (34.2%) of all OHCA victims (Table 1). Further subgroup analysis revealed that, at least in patients treated with MTH, the application of Angio-Seal™ devices was influenced by coronary findings, such as myocardial infarction, percutaneous coronary intervention, or treatment with GP IIb/IIIa inhibitor, with less frequent use of VCDs in more complex procedures (Table 2). However, the use of VCDs was not adapted for further treatment with MTH in general (Table 2, Figure 1). Regardless of whether the OHCA were treated with MTH after coronary angiography or not, we could not observe any difference in the rate of vascular complications or survival rates between patients treated with or without VCD (Table 2).


Using vascular closure devices following out-of-hospital cardiac arrest?

Christ M, von Auenmueller KI, Liebeton J, Grett M, Dierschke W, Noelke JP, Breker IM, Trappe HJ - Int J Med Sci (2015)

Differences within the group of patients treated with vascular closure devices depending on whether they received mild therapeutic hypothermia (MTH) or not.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4402433&req=5

Figure 1: Differences within the group of patients treated with vascular closure devices depending on whether they received mild therapeutic hypothermia (MTH) or not.
Mentions: In our study, VCDs were used in about one third (34.2%) of all OHCA victims (Table 1). Further subgroup analysis revealed that, at least in patients treated with MTH, the application of Angio-Seal™ devices was influenced by coronary findings, such as myocardial infarction, percutaneous coronary intervention, or treatment with GP IIb/IIIa inhibitor, with less frequent use of VCDs in more complex procedures (Table 2). However, the use of VCDs was not adapted for further treatment with MTH in general (Table 2, Figure 1). Regardless of whether the OHCA were treated with MTH after coronary angiography or not, we could not observe any difference in the rate of vascular complications or survival rates between patients treated with or without VCD (Table 2).

Bottom Line: VCDs were used in 26 patients (34.2%), and 48 patients (63.2%) were treated with MTH.While there were significantly more overall vascular complications in the group of patients treated with MTH (12.5% versus 0.0%; p=0.05), vascular complications were similar between patients with VCD or manual compression, regardless of whether or not they were treated with MTH.Therefore, our data suggest that the use of VCDs in victims from OHCA might be feasible and safe in patients treated with MTH as well, at least if the decision to use them is individually carefully determined.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology and Angiology, Marienhospital Herne, Ruhr - University Bochum, Germany.

ABSTRACT

Objectives and background: Despite a generally broad use of vascular closure devices (VCDs), it remains unclear whether they can also be used in victims from out-of-hospital cardiac arrest (OHCA) treated with mild therapeutic hypothermia (MTH).

Methods: All victims from OHCA who received immediate coronary angiography after OHCA between January 1(st) 2008 and December 31(st) 2013 were included in this study. The operator decided to either use a VCD (Angio-Seal™) or manual compression for femoral artery puncture. The decision to induce MTH was based on the clinical circumstances.

Results: 76 patients were included in this study, 46 (60.5%) men and 30 (39.5%) women with a mean age of 64.2 ± 12.8 years. VCDs were used in 26 patients (34.2%), and 48 patients (63.2%) were treated with MTH. While there were significantly more overall vascular complications in the group of patients treated with MTH (12.5% versus 0.0%; p=0.05), vascular complications were similar between patients with VCD or manual compression, regardless of whether or not they were treated with MTH.

Conclusion: In our study, the overall rate of vascular complications related to coronary angiography was higher in patients treated with mild therapeutic hypothermia, but was not affected by the application of a vascular closure device. Therefore, our data suggest that the use of VCDs in victims from OHCA might be feasible and safe in patients treated with MTH as well, at least if the decision to use them is individually carefully determined.

No MeSH data available.


Related in: MedlinePlus