Early ambulation after percutaneous coronary interventions

OBJECTIVES
Early ambulation after coronary interventions may reduce in-hospital stay and add to the patients’ comfort. This approach, however, may increase the risk for puncture site-related complications. We evaluated the safety of early ambulation after elective coronary stenting or angioplasty.

STUDY DESIGN
The study included 342 patients (212 males, 130 females; mean age 53±14 years) undergoing elective coronary stenting or angioplasty using a 6-F guiding catheter through the femoral artery and a standard dose of heparin 5,000 IU. Arterial sheath was removed immediately after the procedure. Homeostasis was achieved by manual compression and maintained with a compressive bandage. Subcutaneous low-molecular-weight heparin was administered one hour after sheath removal. Ambulation was allowed two hours after bed rest. Inguinal complications were recorded during a week follow-up.

RESULTS
Bleeding occurred during ambulation in eight patients (2.3%). No hematoma developed after ambulation during hospital stay. Ecchymosis was the most frequent delayed complication (n=32, 9.4%). Late bleeding was observed in three patients (0.9%) and managed by compression and bed rest. Small hematomas, 1 to 2 cm in diameter, were noted in nine patients (2.6%). A large hematoma requiring blood transfusion and surgical intervention developed in a patient (0.3%) who was obese and had uncontrolled hypertension.

CONCLUSION
Early ambulation after coronary interventions using a 6-F sheath through the femoral route and low-dose procedural heparin and subcutaneous low-molecular-weight heparin one hour after sheath removal is associated with an acceptable rate of insertion site complications.