[Reduction of puncture-induced complications after heart catheterization by optimized compression technique despite reduced compression time. A prospective, duplex ultrasound and pressure controlled study].

The number of local complications after heart catheterization by transfemoral approach can be lowered by optimized compression technique in spite of shortened compression time. It requires a long-term (> 30 minutes) acute compression after removing the sheaths and stable pressure during the following compression period. To achieve this issue the deployment of a novel compression device is superior to the combination of manual compression and conventional pressure dressing. A pressure of 40 to 45 mmHg is sufficient and well tolerated. Local complications as pseudoaneurysms and arteriovenous fistulas are detected by duplexsonography with high sensitivity. Only about 50 percent of pseudoaneurysms are identified by physical examination in contrast to arteriovenous fistulas which are rarely missed because of their characteristic murmur. The early ultrasound-guided compression therapy is considered to be a safe treatment of pseudoaneurysms but is not effective in arteriovenous fistulas. Risk factors of local complications are high blood pressure, multiple arterial puncture and local-anatomical conditions. Compression-related factors are short acute compression (phi 14.3 minutes) and loss of pressure during the following compression period.