Immediate mobilization after coronary angiography or percutaneous coronary intervention following hemostasis with the AngioSeal vascular closure device (the MOBS study)

摘要

Background: In patients undergoing coronary angiography or percutaneous coronary intervention (PCI), the standard post procedure regime includes immobilization and bed rest despite the use of vascular closure devices.Aim: In the Mobilization after Coronary Angiography or Percutaneous Coronary Intervention (MOBS) study we compared bleeding complications after cardiac catheterization with femoral artery access after mobilization immediately off the angiographic table or standard care with1 hour (MOBS I after a diagnostic angiogram) or 2 hours of bed rest before mobilization (MOBS II after PCI).Methods: Bleeding complications were defined as major (requiring surgery of the femoral artery, transfusion or increased hospital stay) and minor (hematoma 5×5 cm2, oozing from the puncture site or minor bleeding that could be compressed manually).Results: In the MOBS I cohort (100 patients were mobilized immediately and 100 patients followed standard care) no major bleeding complications were seen. In the immediate mobilization group 2.0% experienced minor bleeding compared to 4.0% in the standard care group (p=0.41). In the MOBS II cohort after PCI (158 patients were mobilized immediately and 161 patients followed standard care), major bleeding complication rates did not differ significantly between the two groups: immediate mobilization group 26.6% vs. standard care group 28.0%, p=0.78. The majority of bleeding complications were due to oozing: immediate mobilization group 22.8% vs. standard care group 20.5%, p=0.62.Conclusions: Immediate mobilization after a coronary angiogram or PCI with the femoral access site closed by the closure device AngioSeal was not associated with increased bleeding risk compared to standard care with bed rest.