Abstract No. 503 Feasibility and Outcomes of a 15-minute Radial Access Hemostasis Protocol Utilizing a Novel Focused Compression Device and Hemostatic Disk for Interventional Radiology Procedures

Interventional radiology (IR) procedures have increasingly adopted radial access given the safety profile and improved patient satisfaction. Radial artery hemostasis traditionally involves labor-intensive manual compression for 15+ minutes or mechanical compression with recommendations for 45-120+ minutes ( >180+ minutes reported in cardiology literature). Decreased compression time can reduce radial artery occlusion rates. Hemostatic disks can reduce compression time for hemostasis without changing complication rates. The VasoStat focal compression device demonstrates decreased time to hemostasis and simpler application and removal compared to balloon compressive devices. This study evaluates the feasibility and safety of a reduced compression protocol for radial access hemostasis using a novel focal compression device in combination with a hemostatic disk. Between June 2022 and June 2023, a hemostasis protocol utilizing a focal compression device (VasoStat; Forge Medical, Bethlehem, PA) in combination with a hemostatic disk (StatSeal; Biolife, Sarasota, FL) was applied to 51 interventional radiology left radial artery access procedures in 40 patients. All procedures were performed with 6 Fr slender radial access sheaths (Terumo Medical, Tokyo, Japan) with heparin administration per protocol. The compression device was applied per manufacturer guidelines for patent hemostasis and removed after 15 minutes if hemostasis was achieved. Patients were observed an additional 15 minutes prior to discharge with detailed discharge/callback instructions. Patients were followed up within 1 month in IR with physical and/or ultrasound evaluation of the access site. Technical success, defined as hemostasis after 15 minutes of radial artery compression, was achieved in all procedures with no evidence of symptomatic hematoma, rebleeding or additional intervention for hemostasis. All patients were discharged after approximately 15 minutes of additional observation (30 minutes after procedure completion). One incident (2%) of asymptomatic radial artery occlusion was observed on follow up with good collateral flow to the hand and no motor or neurologic deficit. A 15-minute reduced compressive hemostasis protocol appears safe and effective for radial artery access procedures in IR with low occlusion rate and no observed risk of rebleeding. This protocol allows rapid and safe discharge, reducing post-procedural observation time and staffing requirements with simplified device removal.