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

Abstract

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): .

Complicações na descompressão da pulseira hemostática compressiva: uma revisão integrativa

“…Cinco artigos buscaram avaliar a relação de duração da compressão com diminuição das complicações, como exemplo a OAR. Dois artigos compararam tempos de hemostasia e concluiu que, respectivamente, durações mais curtas de tempo de hemostasia radial não reduziram ainda mais o risco dessas complicações (Lavi, et al, 2020) e os diferentes tempos de compressão da artéria radial após a cinecoronariografia não influenciaram significativamente na ocorrência de hemostasia e complicações vasculares, entretanto foi evidenciado um menor número de OAR tardia no grupo de menor tempo de hemostasia (Campos, et al, 2018;Dangoisse, et al, 2017;Pancholy, et al, 2012;Edris, et al, 2015).…”

“…A orientação, a avaliação e o preparo tanto físico quanto emocional dos pacientes fazem parte da assistência prestada de maneira individualizada (Venturi, et al, 2016). Apesar de a literatura ser abrangente quanto à efetividade da pulseira compressiva na hemostasia em razão da utilização do curativo convencional e complicações da utilização da via radial; mesmo que de baixa incidência como, por exemplo, a OAR pouco diagnosticada devido geralmente ser assintomática, esta é a mais comum e acomete de 1 a 10%, sua ocorrência traz um dano ao paciente que inviabiliza a via radial para uso em futuros procedimentos e enxertos em casos de cirurgias de revascularização do miocárdio (Campos, et al, 2018); pouco se foi investigado sobre complicações na descompressão do dispositivo hemostático.…”

Microfluidics-assisted optimization of highly adhesive haemostatic hydrogel coating for arterial puncture

“…The FITC-Gel-TA, RhB-Alg and fluorescein-sodium-decorated fibrin glue were prepared as previously reported 1 [ 7 , 29 ]. The small simulation hydrogel used for microfluidics was prepared by blade cutting under a microscope.…”

“…Bleeding after tissue puncture is the main complication and not only causes psychological fear in patients but also increases the risk of infection and even hemorrhagic shock [ [4] , [5] , [6] ]. Manual compression and patient immobilization are usually used to achieve haemostasis after tissue puncture, which usually takes a few minutes to hours and is often associated with patient discomfort, subcutaneous ecchymosis, local hematoma, and even re-bleeding [ 7 , 8 ]. In addition, for patients whose coagulation function is abnormal (e.g., haemophilia), traditional haemostatic methods usually fail, and the tissue puncture turns out to be a contraindication due to haemorrhage [ 9 , 10 ].…”

Comparison between two protocols for deflation of the TR band following coronary procedures via the radial route

“…Recently, there have been trials which show that an accelerated protocol that starts almost 30 minutes after the sheath removal is safe without an increase in bleeding complications [ 12 , 13 ] but with overall longer time to removal. However, other groups have demonstrated increased bleeding with these accelerated protocols [ 13 , 14 ] and suggested the delayed protocol.…”