Comparative study on the hemostasia by the suture hemostasis device Perclose and manual method after coronary stent implantation in the elderly

Objective To evaluate the advantage and disadvantage of hemostasis done by Perclose device and manual method. In order to provide feasible suggestion for how to treat with the arterial access site after coronary stent implantation in the elderly. Methods Three hundred and twenty-four elderly patients who underwent coronary stents implantation were divided into two groups. 165 patients accepted Perclose device for hemostasis (device group). 159 patients accepted manual method for hemostasis (handwork group). Time to achieve hemostasis and ambulation, complications, patients' discomfort, and nursing time after hemostasis were compared. Results The efficacy and safety of two methods of hemostasis were the same. Time to achieve hemostasis and ambulation, nursing time after hemostasis, complications rates at the femoral access site, and patients' discomfort rates from staying in bed in device group were lower than those in handwork group. But complications rates at the femoral access site were increased significantly in those patients who were treated with Perclose unsuccessfully. Conclusions The advantage of Perclose device hemostasis in elderly was: (1) It was a safe and efficacious method of hemostasis. (2) It could shorten the time to achieve hemostasis and ambulation, it also shortened the nursing time,decreased complications and patients' discomfort rates. The disadvantage was: (1) The cost was very high, (2) Doctors have to deal the femoral access site by manual method under heparinization after unsuccessful suturing, and this would increase complications rate of the femoral access site. This would also aggravate the patients' burden of economy and psyche.