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Post-stent management with a pneumatic groin compression device and self injected low molecular weight heparin.
  1. R. H. Stables,
  2. U. Sigwart
  1. Department of Invasive Cardiology, Royal Brompton Hospital, London.

    Abstract

    BACKGROUND: The benefits of intracoronary 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 suboptimal 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.

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