Comparative Efficacy of Mechanical Versus Manual Compression Techniques on Radial Artery Hemostasis Following Transradial Coronary Angiography: A Meta-Analysis

Mechanical compression for hemostasis posttransradial coronary angiography (CAG) or intervention is hypothesized to be more effective than manual compression owing to a more stable and continuous pressure. However, the current evidence comparing these 2 compression techniques is limited. A comprehensive search of the 3 major electronic databases-PubMed, Google Scholar, and Cochrane Library-was performed from inception to October 24, 2024, to identify relevant studies. Standardized mean difference and risk ratios (RR) with 95% confidence intervals (CIs) were pooled using the Mantel-Haenszel random effects model to calculate effect estimates. Statistical significance was set at P < 0.05. Four studies with 1235 patients undergoing transradial CAG were included [mechanical (n = 450) and manual (n = 785)]. On pooled analysis, the mechanical compression method demonstrated a significantly longer mean time to achieve hemostasis (standardized mean difference: 3.21; 95% CI: 1.71, 4.71; P < 0.0001) than the manual compression method. The risks of radial artery occlusion (RR: 1.05; 95% CI: 0.50, 2.22; P = 0.89), hematoma formation (RR: 1.86; 95% CI: 0.28, 12.40; P = 0.52), and bleeding during compression (RR: 0.23; 95% CI: 0.00, 24.81; P = 0.54) were comparable. Both types of hemostatic compression, manual and mechanical, are equally effective though mechanical compression takes significantly longer to achieve hemostasis. Further prospective randomized studies are needed to corroborate these findings.