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Prevention of Radial Artery Occlusion of 3 Hemostatic Methods in Transradial Intervention for Coronary Angiography

https://doi.org/10.1016/j.jcin.2022.03.011Get rights and content
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Abstract

Objectives

The main objective of this study was to compare the efficacy of 3 hemostatic methods for the prevention of early radial artery occlusion (RAO): standard patent hemostasis, patent hemostasis with ulnar compression or the ulnar artery transient compression facilitating radial artery patent hemostasis (ULTRA) method, and facilitated hemostasis with a hemostatic disc.

Background

There are no prospective randomized studies that compare early RAO rates with the 3 most used nonocclusive hemostatic methods.

Methods

This was a prospective, longitudinal, comparative, and randomized study. The final population analyzed was 1,469, and they were randomized into 3 groups: 491 patients in group 1 with standard patent hemostasis, 490 patients in group 2 with the ULTRA method, and 488 patients in group 3 with facilitated hemostasis with a hemostatic disc.

Results

The RAO rate at 24 hours of the total population analyzed was 4.6%. By hemostasis groups, it was 3.6% for patent hemostasis, 5.5% for the ULTRA method, and 4.7% for facilitated hemostasis with a hemostatic disc, with no statistical difference among the 3 groups (P = 0.387). At 30 days, the overall rate of RAO was 1.8%, and by groups, it was 1.4% for the patent hemostasis group, 1.8% for the ULTRA method group, and 2.2% for the facilitated hemostasis with a hemostatic disc group, respectively (P = 0.185).

Conclusions

The rates of RAO at 24 hours evaluated by plethysmography oximetry and confirmed by ultrasound among 3 current radial hemostasis methods (ie, patent hemostasis, the ULTRA method, and facilitated hemostasis with a hemostatic disc) are not different.

Key Words

patent hemostasis
percutaneous coronary intervention
plethysmography
radial artery

Abbreviations and Acronyms

HD
hemostatic disc
PCI
percutaneous coronary intervention
PH
patent hemostasis
RAO
radial artery occlusion
UFH
unfractionated heparin
ULTRA
ulnar artery transient compression facilitating radial artery patent hemostasis
UM
ULTRA method
US
ultrasound

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