A Comparison of 2 Devices for Radial Artery Hemostasis After Transradial Coronary Intervention

Dai, Neng; Xu, Dan; Hou, Lei; Peng, Wenhui; Wei, Yidong; Xu, Yawei

doi:10.1097/jcn.0000000000000115

Cited by 30 publications

(29 citation statements)

References 23 publications

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“…In a previous study in which was evaluated hemostasis with use of the TR Band® device after radial puncture in patients with acute coronary syndrome and similar sociodemographic characteristics to this study, the incidence of hematoma was 3.4% (all type II) (1) . In another study, were compared two radial compression devices in patients after percutaneous coronary intervention, and was found that 20% of those using the TR Band® device presented minor bleeding (15) . Furthermore, the patients evaluated in our study underwent only a coronary diagnostic procedure, and generally, with a shorter duration than PCI.…”

Section: Discussionmentioning

confidence: 99%

Incidence of hemorrhagic complications with use of a radial compression device: a cohort study

Córdova

Santos

Toebe

et al. 2018

Rev. esc. enferm. USP

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Objective: To examine the incidence of hemorrhagic complications in patients undergoing radial cardiac catheterization and using a hemostatic device for arterial compression. Method: A prospective cohort study conducted with patients undergoing elective cardiac catheterization in two hemodynamic laboratories in southern Brazil. The TR Band® radial compression device was used during 4 hours for hemostasis of the arterial puncture site. Hematomas and minor bleeding were the outcomes evaluated. Results: A total of 244 patients were evaluated. The mean age was 63.5±10.9 years, 61.9% were male, 73.8% had systemic arterial hypertension (SAH) and 42.8% were dyslipidemic. Type I hematoma occurred in 1.2% of patients and minor bleeding in 9% after removal of the device. There was no significant association between hematomas and bleeding, and patients who used oral anticoagulants (p=0.604) and prior use of antiplatelets (p=0.958). Conclusion: The use of the hemostatic device for radial artery compression was safe in clinical practice and there was a low incidence of hematomas and minor bleeding after radial coronary angiography.How to cite this article: Córdova ESM, Santos LR, Toebe D, Moraes MAP, Souza EN. Incidence of hemorrhagic complications with use of a radial compression device: a cohort study. Rev Esc Enferm USP. 2018;52:e03410.

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Section: Discussionmentioning

confidence: 99%

Incidence of hemorrhagic complications with use of a radial compression device: a cohort study

Córdova

Santos

Toebe

et al. 2018

Rev. esc. enferm. USP

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“…In a randomized study with 600 participants, the use of a chitosan-based cushion with hemostatic properties, kept compressed on the site of the introducer after PCI, showed better hemostatic efficacy with less compression time (127.6 ± 33.0 minutes versus 181.6± 32.2; p < 0.001), and a lower incidence of RAO after 24 hours (5.4% versus 11.7%, p < 0.05), and after 30 days (5.0% versus 10.0%; p < 0.05) compared to the use of pneumatic wristbands ( 20 ) . It should be noted that the two types of compression were maintained for at least one hour until the first site evaluation.…”

Section: Discussionmentioning

confidence: 97%

Randomized clinical study on radial artery compression time after elective coronary angiography

Campos

Alves

Tsunemi

et al. 2018

Rev. Latino-Am. Enfermagem

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Objective to compare two compression times of the radial artery after coronary angiography with customized compressive dressing regarding the occurrence of hemostasis and vascular complications.Method a randomized clinical study was carried out in patients undergoing elective transradial coronary angiography in two study groups: (G30), whose compressive dressing was maintained for 30 minutes, and (G60), whose compressive dressing was maintained for 60 minutes, both until the first evaluation of hemostasis. Variables related to patients, procedure, occurrence of hemostasis, and vascular complications were analyzed. Patency of the radial artery was assessed with Doppler vascular ultrasonography, immediately after removing the compressive dressing and 30 days after the procedure.Results the sample consisted of 152 patients in G30 and 151 in G60. Hemostasis was evidenced in the first evaluation in 76.3% of G30 patients and 84.2% of G60 patients (p = 0.063). There were 91 immediate complications, being 53 hematomas and 38 occlusions of the radial artery. We identified 18 late occlusions, 7 (5.5%) in G30 and 11 (8.2%) in G60.Conclusion the different compression times of the radial artery after coronary angiography did not significantly influence the occurrence of hemostasis and vascular complications. Brazilian Registry of Clinical Trials (Rebec): .

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“…Pancholy and colleagues reported RAO incidence of 4.4% at 24 h and 3.2% at 30 d using TR band in a cohort using 5F radial sheaths[ 8 ]. Dai et al[ 11 ] demonstrated that in post-transradial PCI patients, incidence of RAO was at least 11% at 24 h and 10% at 30 d. The study showed that air titration based compression strategy using TR band was superior to non-air titration strategies. However, the study utilized a non-specific, non-personalized method using manufacturer’s instructions.…”

Section: Discussionmentioning

confidence: 99%

“…While several compression bands and techniques tested have demonstrated a modest reduction in RAO, a more pragmatic and effective approach remains to be defined[ 11 ]. Therefore, we aimed to prospectively compare incidence of RAO between two conventional hemostatic compression devices (Safeguard Radial and TR band) using a pragmatic and novel air-inflation technique, in patients post-transradial PCI.…”

Section: Introductionmentioning

confidence: 99%

Randomized study comparing incidence of radial artery occlusion post-percutaneous coronary intervention between two conventional compression devices using a novel air-inflation technique

Voon

Cahill

Mannix

et al. 2017

WJC

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AIMTo compare post-percutaneous coronary intervention (PCI) radial artery occlusion (RAO) incidence between two conventional radial artery compression devices using a novel air-inflation technique.METHODSOne hundred consecutive patients post-PCI were randomized 1:1 to Safeguard or TR band compression devices. Post-radial sheath removal, each compression device was inflated with additional 2 mL of air above index bleeding point during air-filled device application and gradually down-titrated accordingly. RAO was defined as absence of Doppler flow signal performed at 24 h and at 6 wk post-PCI. Patients with missing data were excluded. Statistical significance was defined as P < 0.05.RESULTSAll patients had 6F radial sheath inserted. No significant differences were observed between Safeguard Radial (n = 42) vs TR band (n = 42) in terms of age (63 ± 11 years vs 67 ± 11 years), clinical presentation (electives, n = 18 vs n = 16; acute coronary syndrome, n = 24 vs n = 26) and total procedural heparin (7778 ± 2704 IU vs 7825 ± 2450 IU). RAO incidence was not significantly different between groups at 24 h (2% vs 0%, P = 0.32) and 6 wk (0%, both).CONCLUSIONSafeguard Radial and TR band did not demonstrate significant between-group differences in short-term RAO incidence. Lack of evidence of RAO in all post-PCI patients at 6 wk follow-up, regardless of radial compression device indicate advantage of using the novel and pragmatic air-inflation technique. Further work is required to more accurately confirm these findings.

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A Comparison of 2 Devices for Radial Artery Hemostasis After Transradial Coronary Intervention

Abstract: The application of the chitosan-based pad showed better hemostatic efficacy and a lower incidence of radial artery occlusion after transradial coronary intervention compared with the compression device.

Cited by 30 publications

References 23 publications

Incidence of hemorrhagic complications with use of a radial compression device: a cohort study

Incidence of hemorrhagic complications with use of a radial compression device: a cohort study

Randomized clinical study on radial artery compression time after elective coronary angiography

Randomized study comparing incidence of radial artery occlusion post-percutaneous coronary intervention between two conventional compression devices using a novel air-inflation technique

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