Radial hemostasis: Harder, better, faster, stronger?

Seto, Arnold H.; Kern, Morton J.

doi:10.1002/ccd.27775

Cited by 2 publications

(1 citation statement)

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“…It has also been shown that maintenance of antegrade radial flow during hemostasis (“patent hemostasis”) further reduces RAO 15‐17 . Greater duration and intensity of radial compression appear to increase RAO rates, however, there is no current standard for the length or technique of radial artery compression 18,19 . Informed, in part, by industry recommendations, compression time for diagnostic TRA procedures typically range from 90 to 120 min in the United States, but Asian centers routinely exceed 4–6 hr 18,19 Thus, further refinement of TRA hemostasis techniques remains a worthwhile endeavor.…”

Section: Introductionmentioning

confidence: 99%

Safe and rapid radial hemostasis achieved using a novel topical hemostatic patch: Results of a first‐in‐human pilot study using hydrophobically modified polysaccharide‐chitosan

Anchan

Venturini

Larsen

et al. 2021

Cathet Cardio Intervent

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Background: The transradial approach (TRA) for catheter interventions decreases vascular complications and bleeding versus transfemoral approach. Reducing time to hemostasis and preventing radial artery occlusion (RAO) following TRA are important and incompletely realized aspirations.Objectives: This first-in-human study sought to evaluate the efficacy of a novel, topically applied compound (hydrophobically modified polysaccharide-chitosan, hm-P) plus minimal required pneumatic compression, to achieve rapid radial arterial hemostasis in post-TRA procedures compared with de facto standards.Materials and Methods: About 50 adult patients undergoing 6 French diagnostic TRA procedures were prospectively enrolled. At procedure completion, a topical hm-P impregnated patch was placed over the dermotomy and TR Band (TRB) compression was applied to the access site. This patch was used as part of a novel rapid deflation protocol with a primary outcome of time to hemostasis. Photographic and vascular ultrasound evaluation of the radial artery was performed to evaluate the procedural site.Results: Time to hemostasis was 40.5 min (IQR: 38-50 min) with the majority of patients (n = 39, 78%) not requiring reinflation. Patients with bleeding requiring TRB reinflation were more likely to have low body weight and liver dysfunction, with absence of hypertension and LV dysfunction. The rate of RAO was 0% with predischarge radial artery patency documented in all patients using vascular ultrasound. One superficial hematoma was noted. No late bleeding events or cutaneous reactions were reported in the study follow-up.Conclusions: Topical application of hm-P in conjunction with pneumatic compression was safe and resulted in rapid and predictable hemostasis at the arterial puncture site.

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Section: Introductionmentioning

confidence: 99%