Impact of dedicated hemostasis device for distal radial arterial access with an adequate hemostasis protocol on radial arterial observation by ultrasound

Abstract

There is no established hemostasis method or protocol for the transdistal radial approach. Therefore, this study aimed to determine whether "the PreludeSYNC DISTAL" radial compression device (PSD; Merit Medical Systems, Inc., South Jordan, UT) can effectively prevent distal radial artery (dRA) occlusion following catheterization procedures. This retrospective study analyzed patients who underwent hemostasis using the PSD from January 1, 2019, to March 31, 2019. The primary endpoint was occlusion or excessive stenosis of the radial artery (RA) 1 month after catheterization. Pulsatile blood flow and vessel diameters of the dRA and forearm RA (fRA) were measured using vascular ultrasound before and 1 month after catheterization to determine arterial damage. Secondary endpoints were achievement of hemostasis, bleeding, hematoma, aneurysm, neurological abnormality, and functional disturbance of the fingers or hand. Fifty patients (mean age, 70.9 ± 10.7 years; male, 72.0%) were enrolled in this study. Complete hemostasis was achieved in all cases. Total hemostasis time was 161 ± 45 min. No procedure-associated complications were noted. Pulsations of the dRA and fRA were maintained at 1 month. No functional disturbance or neurological abnormality was observed. Vessel diameters of the dRA and fRA were not significantly different before and 1 month after catheterization. No dissection, pseudoaneurysm, or occlusion/stenosis was observed on ultrasound. Distal radial access with a unique device and protocol effectively achieved hemostasis and prevented injury and occlusion of the dRA and fRA.

Efficacy and safety of distal radial approach for cardiac catheterization: A systematic review and meta-analysis

“…Due to the anatomical features of the distal radial artery, the DRA can reduce the hemostasis time. A new compression hemostasis device for the puncture site of the distal radial artery was also developed, and the safety and efficacy of the device were validated[ 37 ]. Mechanical compression is more convenient and requires fewer human resources in comparison to manual compression[ 38 ].…”

Transradial versus transfemoral access for acute stroke endovascular thrombectomy: a 4-year experience in a high-volume center

“…The left forearm is kept partially flexed over the patient's abdomen with the hand close to the left groin and then taped in place. Another advantage of puncturing the dTRA is that reported patency rates are very high, allowing short hemostatic protocols [46].…”

Anatomical snuff box approach for percutaneous coronary interventions – Current status

“…Recently, some dedicated disposable, hemostatic devices (PSD; Merit Medical Systems, Inc., South Jordan, UT) have been developed for compression at the puncture site of dRA with patent hemostasis protocol. 29 Hemostasis is achieved after 2–3 h and the blood flow is maintained in the dRA without damage at 1 month after catheterization. Hemostatic patches have also been used for hemostasis after dRA approach.…”