Manual compression devices such as the Femo-Stop have the advantage of hands-free operation, less contact with blood, and controlled pressure. When bleeding is difficult to control, the pressure of the device is increased to achieve hemostasis and then decreased every few minutes to the lowest pressure to where no evidence of bleeding is observed through the transparent dome. A two-hour limit is recommended for the use of such a compression device to lower the risk of tissue damage or nerve compression. Use of such a device is contraindicated in patients with severe peripheral vascular disease (PVD) or femoral artery or venous grafts. Compression used in very obese patients may not be adequate to achieve hemostasis.
Vascular closure devices such as a Perclose or Angioseal can be made of collagen plugs and procoagulants. These devices are deployed in the cath lab by the interventional cardiologist. Vascular closure devices are associated with decreased compression time, improved patient comfort, and earlier ambulation, but no significant decreases in bleeding or vascular complications have been found (Shoulders-Odom, 2008).
See the manufacturer’s guidelines and your hospital’s policies for care of each type of device. The goal is to reduce the bed-rest time and allow discharge or early ambulation to avoid pressure sores, back pain, DVT, and other risks of immobility.