Effect of modified pneumatic radial compression with alginate on hemostasis and vascular complications in patients with transradial percutaneous coronary intervention: A randomized clinical trial

To assess whether modification of a radial artery compression device with an alginate dressing can improve the efficiency and safety of the hemostasis process after coronary intervention through radial artery access. This preliminary randomized controlled trial involved 40 patients undergoing transradial percutaneous coronary intervention (PCI) (right radial access, 6F sheath). Patients were randomly assigned to two groups: the intervention group (pneumatic radial compression with an alginate dressing, with deflation of 5 cc every 15 minutes starting at 90 minutes) and the control group (standard compression without an alginate dressing, with deflation of 3 cc every 15 minutes starting at 120 minutes). The primary outcomes were hemostasis time and vascular complications (rebleeding, hematoma, radial artery occlusion [RAO]) within 48 hours. Hemostasis time was significantly shorter in the intervention group compared to the control group (141.0 [SD=19.0] minutes vs. 198.0 [SD=14.0] minutes, P<0.001). There were no significant differences in heparin dosage (P=0.691) or procedure duration (P=0.343). Minor vascular complications occurred in both groups (intervention: 10% rebleeding; control: 5% rebleeding and 10% hematoma), with no RAO in either group. The difference in complication rates was not statistically significant (P>0.050). Modification of the pneumatic radial compression device with alginate dressing and early deflation strategy significantly accelerates post-PCI transradial hemostasis without increasing the risk of vascular complications.