E-Abstract

JACC

Lots of interesting abstracts and cases were submitted for TCTAP 2023. Below are the accepted ones after a thorough review by our official reviewers. Don¡¯t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!

TCTAP A-026

The Comparison of Hemostatic Strategies After Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis

By Anastasya Maria Kosasih, Gusti Ngurah Prana Jagannatha, I Wayan Agus Surya Pradnyana, Putu Febry Krisna Pertiwi, Ida Bagus Satriya Wibawa, Luh Oliva Saraswati Suastika

Presenter

Anastasya Maria Kosasih

Authors

Anastasya Maria Kosasih1, Gusti Ngurah Prana Jagannatha1, I Wayan Agus Surya Pradnyana1, Putu Febry Krisna Pertiwi1, Ida Bagus Satriya Wibawa1, Luh Oliva Saraswati Suastika1

Affiliation

Udayana University, Indonesia1
View Study Report
TCTAP A-026
Adjunctive Procedures (Thrombectomy, Atherectomy, Special Balloons)

The Comparison of Hemostatic Strategies After Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis

Anastasya Maria Kosasih1, Gusti Ngurah Prana Jagannatha1, I Wayan Agus Surya Pradnyana1, Putu Febry Krisna Pertiwi1, Ida Bagus Satriya Wibawa1, Luh Oliva Saraswati Suastika1

Udayana University, Indonesia1

Background

Vascular closure devices (VCDs) are widely used and one of the strategies to achieve hemostasis after procedure especially Percutaneous Coronary Intervention (PCI). Up to the present, manual compression (MC) still remains the standard care for closure of the access site of PCI. The aim of this study is to compare the efficacy and complications of VCDs versus MC in achieving hemostasis. 

Methods

PubMed, Cochrane, Science Direct, and Google Scholar databases were searched for relevant studies published and were reviewed to identify studies which qualify inclusion and exclusion criteria. The efficacy outcomes were time to ambulation, time to discharge, and time to hemostasis. The complication outcomes were major and minor vascular complication, bleeding related complication, and injury related complication. 

Results

We included 21 studies with 16,742 participants. Patients who used VCDs when compared with MC were significantly associated with reduced time to ambulation (MD -1.56 minutes; 95% CI; -1.73 to -1.39 minutes; p < 0.00001; 7 studies), lower time to discharge (MD -16.52 minutes; 95% CI; -20.55 to -12.49 minutes; p < 0.00001; 7 studies) and lower time to hemostasis (MD -10.09 minutes; 95% CI; -10.84 to -9.33 minutes; p < 0.00001; 7 studies). We reported for total vascular complications significant differences between VCDs and MC (OR 0.83; 95% CI (0.73 - 0.95); p = 0.006; I2 = 62%), but for major complications there are no differences between VCDs and MC. The bleeding related injury incidence were lower compared with MC (OR 0.76; 95% CI (0.65 - 0.90); p = 0.002; I2 = 74%) and the injury related complications were also lower on VCDs (OR 0.54; 95% CI (0.38 - 0.76); p = 0.0005; I2 = 10%).

Conclusion

For time to ambulation, time to discharge, and time to hemostasis were associated with reduced time when compared with MC. VCDs also have lower incidence of minor vascular complications, bleeding related injury, and injury related complications. However, no difference was demonstrated in major vascular complications.