Vaso-vagal reactions during femoral arterial sheath removal after percutaneous coronary intervention and impact on cardiac events

We determined whether vaso-vagal syncope during sheath removal after percutaneous coronary intervention leads to a higher incidence of major adverse cardiac events including acute stent thrombosis, in 611 patients who participated in our previous trial assessing the impact of intravenous sedation and local anaesthesia at this time on patient comfort. A total of 35 (5.7%) patients experienced a vaso-vagal reaction. Major adverse cardiac events at day 30 occurred in 5.7% of patients experiencing vaso-vagal syncope and 7.1% of those who did not (p = 1.00) with no case of stent thrombosis in the vaso-vagal group. Whilst unpleasant for patients, we conclude that vaso-vagal syncope during sheath removal after percutaneous coronary intervention is not associated with increased adverse cardiac events in the stent era.