Post-stent management with a pneumatic groin compression device and self injected low molecular weight heparin

摘要

Background—The benefits of intracoro-nary stent implantation are offset by an increased risk of complications at the arterial puncture site and a prolonged hospital stay. Much of this morbidity can be attributed to the generally perceived need to achieve systemic anticoagulation after stent implantation. Aim—To test a simplified protocol for post-stent management using the Femostop pneumatic groin compression device and low molecular weight (fractionated) heparin (LMWH) administered by subcutaneous injection. Patients—A case series of 100 consecutive patients, with stable angina pectoris, undergoing coronary stenting for a sub-optimal result after conventional balloon angioplasty. Methods—All patients were managed with a new post-stent protocol using the Femostop pneumatic groin compression device and LMWH. The incidence of complications and the length of hospital stay were recorded. Results—The clinical course was uncomplicated in 92 patients and their discharge from hospital was achieved on the first post-procedural day for 44 patients and on the second for the remaining 48. The rate of vascular or bleeding complications was 6%. Conclusions—LMWH administered by subcutaneous injection may provide a practical and effective alternative to the use of intravenous heparin when systemic anticoagulation is used after stent implantation.