Allied Professionals (Non-physician submissions only) -> Clinical Research D-PO01 - Featured Poster Session (ID 11) Poster

D-PO01-047 - U Stitch For Venous Hemostasis In Patients Undergoing Leadless Pacemaker Implant: A Nurse Practitioner’s Experience (ID 897)

Disclosure
 S.H. Yoakum: Nothing relevant to disclose.

Abstract

Background: Implantation of the Medtronic leadless pacemaker requires femoral venous access using a large, 27 Fr caliber introducer. Potential complications include groin hematoma, pseudoaneurysm, and arteriovenous fistulas. Many patients who undergo leadless pacemaker implantation have atrial fibrillation and are anticoagulated with either warfarin or a direct oral anticoagulant. Achieving hemostasis of the venous access site is a crucial part of a successful procedure. The optimal way to obtain safe hemostasis has not been well described.
Objective: The purpose of this study was to evaluate the effectiveness of using a 0-prolene U stitch to achieve femoral venous access hemostasis.
Methods: We performed a retrospective analysis of patients undergoing leadless pacemaker implant at our institution. Patients were evaluated for groin complications at discharge and at 30 days and 3 months post implant. All patients’ femoral venous access sites were closed performing U stitch, using 0-prolene suture where two bites are placed around the introducer forming a U and cinched together as the introducer is pulled out. The stitch was removed by the Nurse Practitioner the morning after procedure. Patients were seen in the Nurse Practitioner clinic for follow-up post implant.
Results: 56 patients underwent leadless pacemaker implant between March 2017 and November 2019. In all patients the leadless pacemaker was implanted without complications and hemostasis was achieved by an 0-prolene U stitch at the femoral venous access site. 35 patients (63%) were on oral anticoagulation therapy. 2 patients (4%) experienced minor groin oozing after discharge requiring placement of Steri-strips. There were no AV fistulas or pseudoaneurysms.
Conclusion: Use of an O-prolene U stitch after leadless pacemaker implant is a safe and effective way to achieve venous hemostasis with no complications in follow up.
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