Manual Versus Mechanical Compression of the Radial Artery After Transradial Coronary Angiography

Petroglou, Dimitrios; Didagelos, Matthaios; Chalikias, Georgios K.; Tziakas, Dimitrios; Tsigkas, Grigorios; Hahalis, Georgios; Koutouzis, Michael; Ntatsios, Antonios; Tsiafoutis, Ioannis; Hamilos, Michael I.; Κouparanis, Antonios; Konstantinidis, Nikolaos; Sofidis, Georgios; Pancholy, Samir; Karvounis, Haralambos; Bertrand, Olivier; Ziakas, Antonios

doi:10.1016/j.jcin.2018.03.042

Cited by 38 publications

(27 citation statements)

References 29 publications

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“…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 ]. In the present review, hemostasis was performed by manual compression.…”

Section: Discussionmentioning

confidence: 99%

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

Izumida

Watanabe

Yoshida

et al. 2021

WJC

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BACKGROUND The traditional radial approach (RA) is recommended as the standard method for coronary angiography (CAG), while a distal RA (DRA) has been recently used for CAG. AIM To assess the efficacy and safety of the DRA vs RA during CAG. METHODS The following databases were searched through December 2020: MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, the World Health Organization International Clinical Trials Platform Search Portal, and ClinicalTrials.gov. Individual randomized-controlled trials for adult patients undergoing cardiac catheterization were included. The primary outcomes were the successful cannulation rate and the incidence of radial artery spasm (RAS) and radial artery occlusion (RAO). Study selection, data abstraction and quality assessment were independently performed using the Grading of Recommendations, Assessment, Development, and Evaluation approach. RESULTS Three randomized control trials and 13 registered trials were identified. The two approaches showed similar successful cannulation rates [risk ratio (RR) 0.90, 95% confidence interval (CI): 0.72-1.13]. The DRA did not decrease RAS (RR 0.43, 95%CI: 0.08-2.49) and RAO (RR 0.48, 95%CI: 0.18-1.29). Patients with the DRA had a shorter hemostasis time in comparison to those with the RA (mean difference -6.64, 95%CI: -10.37 to -2.90). The evidence of certainty was low. CONCLUSION For CAG, the DRA would be safer than the RA with comparable cannulation rates. Given the limited data, additional research, including studies with standard protocols, is necessary.

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Section: Discussionmentioning

confidence: 99%

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

Izumida

Watanabe

Yoshida

et al. 2021

WJC

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“…The short hemostasis times of the VasoStat may be attributed to the convex shape of the compression surface and the focused pressure over the entry point of the artery to enable efficient platelet plug formation. The mechanism of the device is designed to emulate that of manual compression, which has been shown to produce hemostasis faster than balloon compression devices [27]. Increased duration of radial artery compression following intervention has also been shown to increase rates of early and chronic radial artery occlusions, suggesting devices that achieve shorter times to hemostasis could potentially reduce instances of RAO [28].…”

Section: Discussionmentioning

confidence: 99%

Nonfemoral Arterial Hemostasis Following Percutaneous Intervention Using a Focused Compression Device

Barrette

Vance

Shamimi-Noori

et al. 2020

Cardiovasc Intervent Radiol

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Purpose Upper extremity and tibiopedal arterial access are increasingly used during endovascular therapies. Balloon compression hemostasis devices in these anatomic locations have been described, but most utilize a compression surface extending well beyond the puncture site. We report single-center experience with an arterial puncture-focused compression device following upper extremity and tibiopedal access. Patients and Methods A series of 249 focused compression hemostasis devices (VasoStat, Forge Medical, Bethlehem, Pennsylvania, USA) were used in 209 patients following lower extremity (n = 63) and upper extremity (n = 186; radial: 90%) arterial access procedures using 4-7 French sheaths. Demographic, operative, and follow-up data were collected. Logistic regression was used to evaluate potential association between patient/operative variables and time to hemostasis. Results Primary hemostasis was achieved in 97.2% (242/ 249) following sheath removal; in 7 cases (2.8%) puncture site oozing occurred after initial device removal and required reapplication. Secondary hemostasis was 100% (249/249). Seven complications (2.8%) were recorded: 5 minor hematomas (2%) and 2 transient access artery occlusions (0.8%). Mean time to hemostasis enabling device removal was 55 ± 28 min. Elevated body mass index (BMI) was not associated with increased time to hemostasis (p = 0.31). Accessed artery, sheath size, and heparin dose were also not associated with time to hemostasis (p = 0.64; p = 0.74; p = 0.75, respectively). Conclusions The focused compression hemostasis device enabled rapid hemostasis with a low complication rate. Time to hemostasis was independent of BMI, access site, sheath size, or heparin dose.

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“…Nevertheless, TRA also has some serious and unresolved problems, including the limitation of the sheath size and RAO, which limits the fRA as a future access site and disturbs creating the shunt for hemodialysis. The reported occlusion rate of the fRA after TRA is 4-12% [15][16][17]. The main causes are fRAs with a small diameter and the hemostasis method.…”

Section: Discussionmentioning

confidence: 99%

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

Kawamura

Yoshimachi

Nakamura

et al. 2020

Cardiovasc Interv and Ther

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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.

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Manual Versus Mechanical Compression of the Radial Artery After Transradial Coronary Angiography

Abstract: Manual and mechanical compression resulted in similar rates of early RAO, although the total duration of hemostasis was significantly shorter in the manual group.

Cited by 38 publications

References 29 publications

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

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

Nonfemoral Arterial Hemostasis Following Percutaneous Intervention Using a Focused Compression Device

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

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