Key result
A new radial compression protocol significantly reduced the incidence of radial artery occlusion to 0.9% compared to 9.8% with the traditional protocol (OR 0.09) in patients undergoing trans-radial coronary angiography.
Why the study?
Hemostasis protocols after trans-radial approach vary widely across institutes without an established evidence-based protocol, prompting investigation into the clinical implications of radial compression protocols.
Does a new rapid-deflation hemostasis protocol reduce radial artery occlusion and hemostasis time compared to a traditional protocol in patients undergoing trans-radial coronary angiography?
Observational (n=1,842)
No
Does a new rapid-deflation hemostasis protocol reduce radial artery occlusion and hemostasis time compared to a traditional protocol in patients undergoing trans-radial coronary angiography?
A new rapid-deflation radial compression protocol significantly shortens hemostasis time and reduces the risk of radial artery occlusion without increasing clinically relevant bleeding.
May support rapid-deflation hemostasis to lower occlusion risk; hypothesis-generating until confirmed in randomized trials.
Protocols for hemostasis after trans-radial approach (TRA) vary depending on the institute as there is no established evidence-based protocol. This study aimed to investigate the clinical implications of radial compression protocols. Consecutive patients who underwent outpatient invasive catheter angiography before and after April 2018 were treated with traditional and new protocols, respectively. Using the same hemostasis band, the amount and timing of deflation were fixed in the traditional protocol, whereas the air was removed as much as possible every 30 min in the new protocol. A total of 1,842 patients (71±10 years old, 77% male) were included. Compared with the traditional protocol group (n=1,001), the new protocol group (n=841) had a significantly lower rate of dual antiplatelet therapy (24% vs. 35%, p<0.001). The time required for complete hemostasis was approximately one-third with the new protocol (66±32 min vs. 190±16 min, p<0.001) with no clinically relevant bleeding. The incidence of radial artery occlusion (RAO) was 9.8% and 0.9% in the traditional and new protocol groups, respectively (p<0.001). After adjusting for covariates, the new protocol was associated with a shorter hemostasis time (odds ratio 0.01, p<0.001) and a reduced risk of RAO (odds ratio 0.09, p<0.001). Our new protocol for hemostasis after TRA was strongly associated with a shorter hemostasis time and a lower rate of RAO.
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Takamatsu et al. (2021) conducted an observational in Trans-radial coronary angiography (n=1,842). New radial compression protocol (frequent air removal) vs. Traditional radial compression protocol was evaluated on Incidence of radial artery occlusion (RAO) at 6 months (OR 0.09, 95% CI 0.04-0.22, p=<0.001). A new radial compression protocol significantly reduced the incidence of radial artery occlusion to 0.9% compared to 9.8% with the traditional protocol (OR 0.09) in patients undergoing trans-radial coronary angiography.
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