Efficacy and safety of kaolin-based hemostatic pad vs. standard mechanical compression following transradial and transulnar access for elective coronary angiography and PCI: RAUL trial substudy

Abstract Hemostatic devices used in the transradial approach (TRA) and transulnar approach (TUA) are limited. This study compared the efficacy and safety of hemostasis using the QuikClot Radial hemostatic pad (QC) vs. standard mechanical compression (SC) after coronary angiography (CAG). This prospective single-center randomized trial included CAG patients. The primary and secondary endpoints were efficacy (successful hemostasis) and safety (total artery occlusion [TAO], pseudoaneurysm, hematoma), respectively. A visual analog scale (VAS) evaluated patient pain during compression. In 2013–2017, 200 patients were randomized 2 × 2 into the: (1) TRA and TUA groups and (2) QC and SC groups. Successful hemostasis was achieved in 92 (92%) patients in the QC group and 100 (100%) patients in the SC group (p < 0.006). The TRA SC subgroup showed significantly better results than the TRA QC subgroup (100% vs. 90.0%; p < 0.03). Similar results were obtained in the TUA QC and TUA SC subgroups (95% vs. 100%; p = 0.5). The secondary endpoint was achieved in the QC and SC groups (8% vs. 9%; p = 0.8). Patients reported significantly less pain during QC application than during SC (VAS: 2.6 ± 2.6 vs. 3.4 ± 2.9; p < 0.03). In patients undergoing CAG with TRA or TUA, QC was associated with lower efficacy, less discomfort, and similar safety compared to SC.

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A Randomized Trial Comparing Short versus Prolonged Hemostasis with Rescue Recanalization by Ipsilateral Ulnar Artery Compression: Impact on Radial Artery Occlusion—The RESCUE-RAO Trial

Journal of Interventional Cardiology ◽

10.1155/2020/7928961 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Dmitrii V. Ognerubov ◽

Alexander Sedaghat ◽

Sergey I. Provatorov ◽

Andrey S. Tereshchenko ◽

Olivier F. Bertrand ◽

...

Keyword(s):

Coronary Angiography ◽

Randomized Trial ◽

Hospital Discharge ◽

Radial Artery ◽

Ulnar Artery ◽

Artery Occlusion ◽

Puncture Site ◽

Coronary Procedures ◽

Baseline Characteristics ◽

Radial Artery Occlusion

Background. Despite the enormous benefits of radial access, this route is associated with a risk of radial artery occlusion (RAO). Objective. We compared the incidence of RAO in patients undergoing transradial coronary angiography and intervention after short versus prolonged hemostasis protocol. Also we assessed the efficacy of rescue 1-hour ipsilateral ulnar artery compression if RAO was observed after hemostasis. Material and Methods. Patients referred for elective transradial coronary procedures were eligible. After 6 F radial sheath removal, patients were randomized to short (3 hours) (n = 495) or prolonged (8 hours) (n = 503) hemostasis and a simple bandage was placed over the puncture site. After hemostasis was completed, oximetry plethysmography was used to assess the patency of the radial artery. Results. One thousand patients were randomized. Baseline characteristics were similar between both groups with average age 61.4 ± 9.4 years (71% male) and PCI performed on half of the patients. The RAO rate immediately after hemostasis was 3.2% in the short hemostasis group and 10.1% in the prolonged group ( p < 0.001 ). Rescue recanalization was successful only in the short group in 56.2% (11/19); at hospital discharge, RAO rates were 1.4% in the short group and 10.1% in the prolonged group ( p < 0.001 ). Conclusion. Shorter hemostasis was associated with significantly less RAO compared to prolonged hemostasis. Rescue radial artery recanalization was effective in > 50%, but only in the short hemostasis group.

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Efficacy and safety of direct aspiration first pass technique versus stent-retriever thrombectomy in acute basilar artery occlusion—a retrospective single center experience

Neuroradiology ◽

10.1007/s00234-017-1802-6 ◽

2017 ◽

Vol 59 (3) ◽

pp. 297-304 ◽

Cited By ~ 16

Author(s):

Johannes C. Gerber ◽

Dirk Daubner ◽

Daniel Kaiser ◽

Kay Engellandt ◽

Kevin Haedrich ◽

...

Keyword(s):

Basilar Artery ◽

Artery Occlusion ◽

Stent Retriever ◽

Basilar Artery Occlusion ◽

Efficacy And Safety ◽

Single Center ◽

Single Center Experience ◽

First Pass

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Efficacy and safety of the distal transradial approach in coronary angiography and percutaneous coronary intervention: a Japanese multicenter experience

Cardiovascular Intervention and Therapeutics ◽

10.1007/s12928-019-00590-0 ◽

2019 ◽

Vol 35 (2) ◽

pp. 162-167 ◽

Cited By ~ 7

Author(s):

Yukio Mizuguchi ◽

Takuya Izumikawa ◽

Sho Hashimoto ◽

Takeshi Yamada ◽

Norimasa Taniguchi ◽

...

Keyword(s):

Percutaneous Coronary Intervention ◽

Coronary Angiography ◽

Coronary Intervention ◽

Efficacy And Safety ◽

Transradial Approach ◽

Percutaneous Coronary

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Impact of the Use of a Larger Forearm Artery on the Efficacy and Safety of Transradial and Transulnar Access: A Randomized Trial with Preprocedural Ultrasonography

Journal of Clinical Medicine ◽

10.3390/jcm9113607 ◽

2020 ◽

Vol 9 (11) ◽

pp. 3607

Author(s):

Pawel Lewandowski ◽

Anna Zuk ◽

Tomasz Slomski ◽

Pawel Maciejewski ◽

Bogumil Ramotowski ◽

...

Keyword(s):

Randomized Trial ◽

Vascular Complications ◽

Ulnar Artery ◽

Coronary Intervention ◽

Artery Occlusion ◽

Percutaneous Coronary ◽

Secondary Endpoints ◽

The Impact ◽

Selection Of

(1) Background: We aimed to assess the impact of the selection of a larger radial or ulnar artery on the efficacy of access and vascular complications, based on preprocedural ultrasonographic examination. (2) Methods: This prospective, randomized trial included patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI). Patients were randomized into either a larger ulnar artery (UA) or radial artery (RA) group or smaller UA/RA group. The primary endpoint was successful CAG/PCI without crossover to another artery. The secondary endpoints were incidences of radial or ulnar artery occlusion (RAO/UAO) at the 24 h and 30 day follow-up. (3) Results: Between 2017 and 2018, 200 patients (107 men, mean age 68 ± 8 years) were enrolled. The success of CAG/PCI via the access site was 98% and 83% (p < 0.001) in the larger UA/RA group and smaller UA/RA group, respectively. The independent factor for CAG/PCI success was the larger artery (OR 9.8, 95%CI 2.11–45.5; p < 0.005). The larger UA/RA was superior, with RAO/UAO at 24 h: OR 0.07, 95%CI 0.09–0.61; p < 0.016; and RAO/UAO at 30 days: OR 0.25, 95%CI 0.05–0.12; p < 0.001. (4) Conclusions: Larger artery access was shown to be more efficient and safer than recessive forearm artery access.

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Efficacy and safety of transulnar coronary angiography and interventions-A single center experience

Catheterization and Cardiovascular Interventions ◽

10.1002/ccd.24989 ◽

2013 ◽

Vol 83 (1) ◽

pp. E26-E31 ◽

Cited By ~ 7

Author(s):

Anand R. Deshmukh ◽

Manu Kaushik ◽

Ahmed Aboeata ◽

Jamil Abuzetun ◽

Tammy L. Burns ◽

...

Keyword(s):

Coronary Angiography ◽

Efficacy And Safety ◽

Single Center ◽

Single Center Experience

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Single-Center Noninferiority Randomized Trial on the Efficacy and Safety of Low- and High-Dose Rush Oral Milk Immunotherapy for Severe Milk Allergy

International Archives of Allergy and Immunology ◽

10.1159/000508627 ◽

2020 ◽

Vol 181 (9) ◽

pp. 699-705

Author(s):

Yuri Takaoka ◽

Yuko Yajima ◽

Yoichi M. Ito ◽

Junko Kumon ◽

Takahiro Muroya ◽

...

Keyword(s):

Randomized Trial ◽

High Dose ◽

Milk Allergy ◽

Efficacy And Safety ◽

Single Center

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Mo1540 THE EFFICACY AND SAFETY OF GCWB104 (FLOS LONICERA EXTRACT) IN FUNCTIONAL DYSPEPSIA: A SINGLE-CENTER, RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY

Gastroenterology ◽

10.1016/s0016-5085(20)32906-1 ◽

2020 ◽

Vol 158 (6) ◽

pp. S-887-S-888

Author(s):

Nayoung Kim ◽

Yonghoon Choi ◽

Dong Ho Lee

Keyword(s):

Functional Dyspepsia ◽

Controlled Study ◽

Efficacy And Safety ◽

Single Center ◽

Double Blind ◽

Double Blind Placebo

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Efficacy of ethanol ablation for treatment of benign cystic thyroid nodules: the first hospital-based study in Vietnam

MedPharmRes ◽

10.32895/ump.mpr.4.1.5 ◽

2020 ◽

Vol 4 (1) ◽

pp. 18-22

Author(s):

Van Bang Nguyen ◽

Van Vy Hau Nguyen ◽

Binh Thang Tran ◽

Chi Van Le

Keyword(s):

Thyroid Nodules ◽

Multiple Logistic Regression Analysis ◽

Volume Reduction ◽

Efficacy And Safety ◽

Inclusion Criteria ◽

Ethanol Ablation ◽

Institutional Review ◽

Thyroid Cyst ◽

Secondary Endpoints ◽

Written Informed Consent

Background: In Vietnam, surgery or aspiration is preferred to treat thyroid cysts however each of them still have limitations. Purposes of this study were to evaluate the efficacy and safety of ethanol ablation in treating thyroid cysts and determine factors that predict the outcome of treatment. Methods: This prospective study was approved by the Ethics Committee of the Institutional Review Board of Family hospital and written informed consent for procedures was obtained. From May 2018 to March 2019, 23 patients who underwent treatment for thyroid cysts by EA were enrolled in this study and were followed up for 1 month at Family hospital. The primary endpoint was efficient after one month as the volume reduction ratio was ≥ 50%. Secondary endpoints were improvements in symptoms, cosmetic scores, and safety. Multiple logistic regression analysis was used. Results: In the finding, from May 2018 to March 2019, only 17 patients who matched inclusion criteria were included in the analyst, including 7 purely thyroid cysts, and 10 predominantly cystic nodules. Mean volume decreased significantly from 5.21 ± 3.37 ml to 2.35 ± 2.52 ml in corresponding to 52.87% of volume reduction with p < 0.05. Ethanol ablation (EA) success rate was 52.90% after 1 month. Symptoms and cosmetic scores were improved significantly. The thyroid function was constant. No adverse events occurred. Purely thyroid cyst was a predictive factor contributing to the success of EA. Conclusion: EA seems likely to be a safe and an efficient therapy for patients who had purely or predominantly cystic thyroid nodules.

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