• Accelerated patent hemostasis using a procoagulant disk; a protocol designed to minimize the risk of radial artery occlusion following cardiac catheterization

    Abstract

    Purpose

    Radial artery occlusion flowing cardiac catheterisation has been linked to flow reduction and prolonged compression. We investigate whether these factors can be optimised following transradial cardiac catheterisation by using an accelerated band removal protocol facilitated by a haemostasis promoting pad, in combination with a patent haemostasis technique.

    Methods

    In this single centre prospective study, 389 consecutive patients undergoing TRA for coronary angiography or angioplasty were randomised to two haemostasis protocols: use of a Helix™ compression device alone (HC) or in combination with a haemostatic pad (StatSeal® disc) and an accelerated haemostasis protocol (AC). A patent haemostasis technique was employed in both study arms. The primary efficacy endpoint was the time to haemostasis and the secondary safety outcome was access site related complications: re-bleeding, haematoma and radial artery patency assessed within 24 h using reverse Barbeau's Test (BT).

    Results

    Between May and Nov 2017, 191 patients were randomised to receive HC and 198 patients to AC. Compression time was significantly higher with HC as compared to AC (165.8 ± 63.1 versus 79.7 ± 41.2 min, < 0.001). There were no significant differences in re-bleeding and RAO between groups (3.7% versus 5.6%, = 0.37 and 6.3% versus 4.1%, = 0.33) respectively. Incidence of haematoma was higher in AC group (4.7% versus 12.1%, p= 0.009).

    Conclusion

    A reduction in radial artery compression time can be achieved by using Statseal in association with an accelerated haemostasis protocol without increasing the risk of access site bleeding and RAO. The combination of reduced compression time combined with maintained radial flow via patent haemostasis has the potential to reduce the risk of radial occlusion after transradial catheterisation.

    Highlights

     

    • Radial artery occlusion has been linked to flow reduction and prolonged compression time.
    • We investigated the practicality of an accelerated band removal protocol, using a hemostatic pad with patent haemostasis.
    • Post coronary procedures, 389 patients were randomized to receive standard or accelerated compression protocols.
    • The compression time with accelerated protocol was significantly reduced by >1/3, compared to standard technique.
    • Secondary outcomes were similar in groups apart from a higher incidence of haematoma in accelerated compression group.

    Author bio

    Cardiovascular Revascularization Medicine, 2019-02-01, Volume 20, Issue 2, Pages 137-142, Copyright © 2018 Elsevier Inc.

     

    Source:

    Read the original article on Science Direct: Accelerated patent hemostasis using a procoagulant disk; a protocol designed to minimize the risk of radial artery occlusion following cardiac catheterization

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