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

Eid-Lidt, Guering; Reyes-Carrera, Jesús; Farjat‐Pasos, Julio I.; Saenz, Arnoldo Loaisiga; Bravo, Carlos Aguila; Rangel, Sara Nieto; Salido, Daniel Zazueta; Servin, Norman Said Vega; Soto-López, María E.; Gaspar, Jorge

doi:10.1016/j.jcin.2022.03.011

Cited by 5 publications

(6 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…shown in a recent study, where ulnar compression was applied directly and broadly on the distal forearm. 9 Although retrospective, this is the first data set studying the interaction between introducer size and hemostasis technique, demonstrating the larger magnitude of RAO preventive effect of hemostasis technique compared to introducer size.…”

Section: Discussionmentioning

confidence: 86%

“…The two‐bladder device used in this study cohort applies pressure on the ulnar artery at the level of the Guyon's canal in the distal‐most aspect of the forearm, with the pressure directed away from the radial artery and the encapsulated interosseous compartment, hence minimizing the likelihood of unintended radial artery compression by the ulnar compression element. This difference, amongst other limitations, may have been the operating mechanism for the lack of benefit of ulnar compression shown in a recent study, where ulnar compression was applied directly and broadly on the distal forearm 9 …”

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

Evaluation of the incidence of radial artery occlusion using different introducer sheaths and hemostasis techniques

Patel

Sethi

Patel

et al. 2022

Cathet Cardio Intervent

View full text Add to dashboard Cite

Background: Radial artery occlusion (RAO) remains one of the most important complications of transradial access (TRA). Despite the identification of multiple predictors, the interaction between these predictors on the occurrence of RAO has not been evaluated.Methods: Consecutive patients undergoing TRA coronary angiography (CA) or percutaneous coronary intervention (PCI), were retrospectively analyzed to compare the effect of standard patent hemostasis using a one-bladder band versus twobladder band with simultaneous ipsilateral ulnar artery compression and two introducer sizes on the primary endpoint of RAO. Access was obtained using 6-Fr slender introducer sheath or 7-Fr slender introducer sheath and hemostasis with either a one-bladder band or a two-bladder band. The radial artery was evaluated using ultrasound.Results: Total of 2019 patients undergoing CA or PCI were included in the analysis.In the one-bladder band group, the incidence of RAO with a 6-Fr slender introducer sheath was 4.2%. In those receiving hemostasis with a two-bladder band, RAO occurred in 1% of patients receiving a 6-Fr slender introducer sheath versus 0.9% in those receiving a 7-Fr slender introducer sheath (p = 0.68). Larger radial artery diameter, larger body weight, and a two-bladder hemostasis band with ipsilateral ulnar compression were independently associated with a lower incidence of RAO. Conclusion:A two-bladder band with simultaneous ipsilateral ulnar artery compression when used for radial artery hemostasis, is associated with a lower incidence of RAO, and can mitigate the penalty for a larger catheter with reassuring implications for use of a 7-Fr capable system for complex transradial PCI.

show abstract

Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 97%

Evaluation of the incidence of radial artery occlusion using different introducer sheaths and hemostasis techniques

Patel

Sethi

Patel

et al. 2022

Cathet Cardio Intervent

View full text Add to dashboard Cite

show abstract

“…The PRISMA flow diagram for study search and selection is shown in Figure 1 . Of the 316 citations screened, a total of 6 studies, including 6793 patients, were identified and included in the final analysis [ 12 , 23 , 24 , 25 , 26 , 27 ]. Details on the search strategy are reported in the Supplementary Materials .…”

Section: Resultsmentioning

confidence: 99%

“…Coronary angiography alone was performed in one study [ 9 ], PCI following coronary angiography was performed in a variable proportion of patients ranging from 15.6% to 58.7% across 4 studies [ 23 , 25 , 26 , 27 ], while no information was available in one study [ 24 ]. Patients presenting with acute coronary syndrome were excluded in two studies [ 12 , 26 ], data regarding the clinical syndrome were reported in two studies [ 23 , 25 ], with the proportion of acute coronary syndrome ranging from 30.2% to 88.7%, and no information was available in 2 studies [ 24 , 27 ]. The best recommendations for the detection and prevention of RAO were followed in all included studies [ 10 ].…”

Section: Resultsmentioning

confidence: 99%

“…For instance, 5 French (Fr) access site sheath was used in 2 studies [ 12 , 24 ], 6 Fr access size sheath in 2 studies [ 26 , 27 ] and in the majority of cases (from 95.1% to 96.3%) in two studies [ 23 , 25 ]. Compression of the ulnar artery was achieved with a dedicated ulnar artery compression device comprising a double-balloon band system [ 23 , 24 ], a second radial band device adapted to the ulnar artery [ 26 , 27 ], or by compressing a cylindrical composite of gauze or the barrel of a plastic syringe at the Guyon’s canal with a Hemoband (Hemoband Corporation, Portland, Oregon) [ 12 , 25 ]. Transient ulnar artery compression (1 h) was performed in all studies but one [ 12 ], in which continuous compression following the radial artery compression time was applied.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Simultaneous Radial and Ipsilateral Ulnar Artery Compression versus Isolated Radial Artery Compression after Conventional Radial Access for Coronary Angiography and/or Intervention: A Systematic Review and Meta-Analysis

Condello

Cacia

Sturla

et al. 2022

JCM

View full text Add to dashboard Cite

Background: Simultaneous ulnar and radial artery compression (SURC) has emerged as a strategy to increase radial artery flow and mitigate radial artery occlusion (RAO) while achieving adequate hemostasis after transradial access (TRA), though its technical adoption has been limited worldwide. Methods: A systematic search of studies comparing SURC versus isolated radial artery compression after TRA for coronary angiography and/or intervention was performed. Data were pooled by meta-analysis using random-effects models. Odds ratios (OR) with relative 95% confidence intervals (CI) and standardized mean difference were used as measures of effect estimates. The primary endpoint was the occurrence of overall RAO. Results: A total of 6 studies and 6793 patients were included. SURC method as compared to isolated radial artery compression was associated with a lower risk of RAO both overall (OR 0.29; 95% CI, 0.13–0.61, p < 0.001; number needed to treat to benefit [NNTB] =38) and in-hospital (OR 0.28; 95% CI: 0.10 to 0.75; p = 0.01, NNTB = 36), with a reduced risk of unsuccessful patent hemostasis (OR: 0.13; 95% CI: 0.02 to 0.85; p = 0.03, NNT = 5) and upper extremity pain (OR: 0.48; 95% CI: 0.24 to 0.95; p = 0.04, NNTB = 124). No significant difference was observed in hemostasis time and in the risk of hematoma. Conclusion: Compared to isolated radial artery compression, SURC is associated with lower risk of RAO, unsuccessful patent hemostasis, and reported upper limb pain, without any trade-off in safety outcomes. With further development of dedicated dual compression devices, the proposed technique should be freed from usage constraints.

show abstract

Radial Artery Access

Pruthi

Shah

2022

JACC: Cardiovascular Interventions

View full text Add to dashboard Cite

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

Cited by 5 publications

References 14 publications

Evaluation of the incidence of radial artery occlusion using different introducer sheaths and hemostasis techniques

Evaluation of the incidence of radial artery occlusion using different introducer sheaths and hemostasis techniques

Simultaneous Radial and Ipsilateral Ulnar Artery Compression versus Isolated Radial Artery Compression after Conventional Radial Access for Coronary Angiography and/or Intervention: A Systematic Review and Meta-Analysis

Radial Artery Access

Contact Info

Product

Resources

About