scholarly journals Impact of Radial Compression Protocols on Radial Artery Occlusion and Hemostasis Time

2021 ◽  
Author(s):  
Sachiko Takamatsu ◽  
Nobuyuki Kagiyama ◽  
Naohiko Sone ◽  
Kiyotaka Tougi ◽  
Shuichiro Yamauchi ◽  
...  
Keyword(s):  
Radial Artery ◽  
Odds Ratio ◽  
Dual Antiplatelet Therapy ◽  
Artery Occlusion ◽  
Evidence Based ◽  
Radial Compression ◽  
Protocol Group ◽  
Before And After ◽  
Radial Artery Occlusion ◽  
Time Required

Abstract Protocols for hemostasis after trans-radial approach (TRA) vary depending on the institute as there is no established evidence-based protocol. This study aimed to investigate the clinical implications of radial compression protocols. Consecutive patients who underwent outpatient invasive catheter angiography before and after April 2018 were treated with traditional and new protocols, respectively. Using the same hemostasis band, the amount and timing of deflation were fixed in the traditional protocol, whereas the air was removed as much as possible every 30 min in the new protocol. A total of 1,842 patients (71±10 years old, 77% male) were included. Compared with the traditional protocol group (n=1,001), the new protocol group (n=841) had a significantly lower rate of dual antiplatelet therapy (24% vs. 35%, p<0.001). The time required for complete hemostasis was approximately one-third with the new protocol (66±32 min vs. 190±16 min, p<0.001) with no clinically relevant bleeding. The incidence of radial artery occlusion (RAO) was 9.8% and 0.9% in the traditional and new protocol groups, respectively (p<0.001). After adjusting for covariates, the new protocol was associated with a shorter hemostasis time (odds ratio 0.01, p<0.001) and a reduced risk of RAO (odds ratio 0.09, p<0.001). Our new protocol for hemostasis after TRA was strongly associated with a shorter hemostasis time and a lower rate of RAO.

scholarly journals Impact of radial compression protocols on the compression time and radial artery occlusion

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Takamatsu ◽  
N Kagiyama ◽  
T Shiomi ◽  
M Mizobuchi ◽  
N Sone ◽  
...  
Keyword(s):  
Body Size ◽  
Radial Artery ◽  
Major Bleeding ◽  
Artery Occlusion ◽  
Radial Compression ◽  
Complication Rates ◽  
Compression Time ◽  
Significant Difference ◽  
Before And After ◽  
Radial Artery Occlusion

Abstract Background Trans-radial access (TRA) has been established as a safe and established approach for invasive coronary catheter procedures. However, protocols for post-procedural hemostasis varies depending on institutes and an evidence-based protocol is lacking. Purpose The objective of this study was to investigate the clinical implications of procedural hemostasis. Methods Consecutive patients who were referred to outpatient catheter examination before and after April 2018 were treated with an old and a new protocol, respectively. In both protocols, we used the same commercially available hemostasis band with injecting an air of 16 ml for hemostasis. In the old protocol, the amount and timing of deflation were fixed, whereas the air was removed as much as possible for every 30 minutes in the new protocol. Time to complete hemostasis, the rate of major bleeding, and the rate of radial artery occlusion (RAO) at 6 months after the catheter examination were compared between the protocols. Results Total of 1,843 (71±10 years old, 77% male) patients was included in the study. Between patients in the old and the new protocol group (n=1,000 and 843, respectively), there was no significant difference in age, gender, body size, or systolic blood pressure. The new group had significantly higher prevalence of diabetes (47% vs 39%, p=0.002), slightly larger sheath size (4.1±0.3 vs 4.0±0.2 Fr, p&lt;0.001), and lower rate of dual antiplatelet therapy (DAPT: 24% vs. 35%, p&lt;0.001). Time for complete hemostasis was about one-third with the new protocol compared with the old protocol (65±32 vs. 190±16 min, p&lt;0.001) and there was no major bleeding in either group. The rate of radial artery occlusion was 0.7% and 9.8% in the old and the new group (p&lt;0.001). Multivariate analysis showed that the significant predictor of prolonged hemostasis time were the old protocol (odds ratio: OR 80.5, p&lt;0.001) and the prescription of DAPT (OR 2.9, p&lt;0.001), while the factors associated with higher risk of radial occlusion were the old protocol (OR 13.9, p&lt;0.001), the number of previous TRA (OR 1.1, p&lt;0.001), and smaller body size (OR 0.127 per 1 m2 increase p=0.005). Conclusions Our new protocol for hemostasis after TRA was strongly associated with shorter hemostasis time and a lower rate of radial artery occlusion. This approach will decrease the post-procedural hospital time with even fewer complication rates. Study outline Funding Acknowledgement Type of funding source: None

Preventing Radial Artery Occlusion by Using Reverse Barbeau Assessment: Bringing Evidence-Based Practice to the Bedside

2015 ◽  
Vol 35 (4) ◽  
pp. 77-82 ◽  
Author(s):  
Colleen Bonnett ◽  
Nancy Becker ◽  
Brenda Hann ◽  
Annette Haynes ◽  
Jennifer Tremmel
Keyword(s):  
Radial Artery ◽  
Evidence Based Practice ◽  
Artery Occlusion ◽  
Evidence Based ◽  
Radial Artery Occlusion

scholarly journals Use of a Selective Radial Compression Device to Prevent Radial Artery Occlusion After Coronary Invasive Procedure

2014 ◽  
Vol 22 (2) ◽  
pp. 115-119
Author(s):  
Robson Alves Barbosa ◽  
Mônica Vieira Athanazio de Andrade ◽  
Pedro Beraldo de Andrade ◽  
Fábio Salerno Rinaldi ◽  
Igor Ribeiro de Castro Bienert ◽  
...  
Keyword(s):  
Radial Artery ◽  
Invasive Procedure ◽  
Artery Occlusion ◽  
Radial Compression ◽  
Compression Device ◽  
Radial Artery Occlusion

scholarly journals Distal Trans-Radial Approach for Coronary Angiography and Percutaneous Coronary Interventions - Single-Centre Experience

2021 ◽  
Vol 26 (1) ◽  
pp. 13-16
Author(s):  
Maged Mokbel ◽  
Nicolae Florescu ◽  
Crina Julieta Sinescu
Keyword(s):  
Radial Artery ◽  
Artery Occlusion ◽  
Hand Position ◽  
Single Centre ◽  
Single Centre Experience ◽  
Percutaneous Coronary ◽  
Single Centre Study ◽  
Radial Artery Occlusion ◽  
Procedural Success ◽  
Time Required

Abstract Right distal transracial approach in the anatomical snuff box could reduce the probability of radial artery occlusion. Also, that approach allows a more comfortable hand position, especially in obese patients. We prospectively evaluated right distal transracial approach (DTRA) in patients treated trans-radially. Materials and methods: Prospective, observational, single centre study. Various relevant objectives were assessed, for example radial artery occlusion in the evaluated patients at discharge by ultrasonography, procedural success, time of scopy and time required for haemostasis. 57 eligible patients were included in the study. The mean age was 63 years, 63% men, and PCI was performed in 37% of patients. In all patients we used 6Fr radial sheaths, standard catheters and TR-band with verification after one hour, then within 30-minute intervals. Results: Procedural success was 89.5%, no patients had radial artery occlusion, two patients had a local hematoma remitted later, the medium time required for hemostasis was 83.5 minutes, no patients suffered ischaemia or any effect in right hand’s functions. Conclusion: Distal radial puncture seems feasible, safe and can be considered routinely.

scholarly journals Use of a Selective Radial Compression Device to Prevent Radial Artery Occlusion After Coronary Invasive Procedure

2014 ◽  
Vol 22 (2) ◽  
pp. 115-119 ◽  
Author(s):  
Robson Alves Barbosa ◽  
Mônica Vieira Athanazio de Andrade ◽  
Pedro Beraldo de Andrade ◽  
Fábio Salerno Rinaldi ◽  
Igor Ribeiro de Castro Bienert ◽  
...  
Keyword(s):  
Radial Artery ◽  
Invasive Procedure ◽  
Artery Occlusion ◽  
Radial Compression ◽  
Compression Device ◽  
Radial Artery Occlusion

Is radial artery occlusion and local vascular complications following transradial coronary procedures affected by the type of haemostasis device used? A non-inferiority Randomized Controlled Trial (RadCom trial)

2021 ◽  
Author(s):  
Nicole Due-Tønnessen ◽  
Cecile H Egeland ◽  
Oliver J Meyerdierks ◽  
Anders Opdahl
Keyword(s):  
Radial Artery ◽  
Controlled Trial ◽  
Vascular Complications ◽  
Artery Occlusion ◽  
Radial Compression ◽  
Complication Rates ◽  
Access Site ◽  
Randomized Controlled ◽  
Coronary Procedures ◽  
Radial Artery Occlusion

Abstract Aims Vascular access site complications following transradial coronary procedures are less common and severe compared to femoral approach. Radial artery occlusion is considered the main adverse effect. As radial access is gaining more acknowledgement, complication awareness, and understanding is important. The aim was to assess complication rates following transradial coronary procedures and to compare two radial compression devices in a non-inferiority randomized controlled trial. Methods and results Four hundred and ninety-nine patients were randomized to radial compression with a new device (RY Stop, n = 248) or the reference device (TR Band, n = 251) following transradial coronary procedures. Radial artery occlusion persistent at 90 days was the primary endpoint. Discomfort and accounts of vascular complications at access site were secondary endpoints. Radial artery occlusion was observed in 5% (n = 26) for the entire cohort with no difference between groups (RY Stop 6% vs. TR Band 5%; P = 0.69). Patients overall reported low levels of discomfort and the median scores were similar in both groups; RY Stop: 7 vs. TR Band: 10 (P = 0.90). There were few incidents of bleeding (7%), however, they were significantly more frequent with the RY Stop (12%) than with the TR Band (3%; P = 0.001). Few patients (4%) developed access site haematomas, and the incidence was similar in the two groups (P = 0.98). Conclusion We observed a radial artery occlusion rate of 5% at 90 days post-procedure. Access site discomfort and vascular complication rates were low. Overall, the RY Stop compression device was not inferior to the TR Band except occurrences of bleeding.

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