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Evidence Based Practice - Vascular Bleeding Following PCI - Essay Example

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Four articles were analyzed to answer the question, “In patients receiving stents via cardiac catheterization, will insertion of a vascular closure device (VCD), as compared to the current standard of care (manual compression (MC), increase the risk of bleeding?” Because…
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Evidence Based Practice - Vascular Bleeding Following PCI
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Evidence Based Practice - Vascular Bleeding Following PCI

Download file to see previous pages... 3.0%), particularly hematoma (1.1% vs. 2.5%) and pseudoaneurysm (0.1% vs. 1.0%), as compared to MC use (n = 951). Odds ratio of developing complications for VCD recipients was 0.56 (95% CI: 0.40 – 0.79). Because baseline characteristics between treatment groups were initially different, statistical adjustment was done.
In 2010, a prospective, small-scale, short-term case-series study involving 413 patients treated of acute coronary syndrome was used to identify predictors of vascular complications. The use of VCDs by the sample was fairly limited, only 62 used Angio-Seal and 19 had PerClose. For those who used VCDs, there were no significant differences in the occurrence of hematoma during or after the use of procedure. In addition, those with complications were old and had significantly higher systolic blood pressure, as compared to those that did not have complications (Sulzbach-Hoke, Ratcliffe, Kimmel, Kolansky, & Polomano, 2010).
The different VCDs were also compared. In patients that have received PCI in the past eight years, those who underwent VCD (n = 2, 814) had significantly lower incidence rate of ≥ 10 cm hematoma as compared to those who were given MC (n = 1, 407), 1.1% vs. 2.1%. Baseline characteristics between VCD and MC groups were not statistically different. Comparison among Angio-Seal, Perclose and Starclose users revealed that those who used Perclose had the least rate of complications (5.6%), while those receiving Starclose had the most (10.2%). The differences among rates were significant (Iqtidar, Li, Mather, & McKay, 2011).
A similar, wider scale, retrospective study (n = 1, 819, 611) was conducted 2012 by Tavris, et al. The rates of bleeding in Angio-Seal (28.7%), Perclose (8.3%), Boomerang Closure Wire (BCW) (0.6%) and hemostasis patches (7.9%) VCDs were less than 1%, while those receiving MC (38.9%) was 1.18%. In contrast, StarClose (4.4%) and Mynx ...Download file to see next pagesRead More
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