Comparison of short- and long-term haemostatic compression after transradial procedures

Background: Rates of transradial coronary procedures are increasing due to substantial benefits compared with the transfemoral approach. There is no standard in type or length of compression of the puncture site. The aim of the study was to compare two different schemes of haemostatic compression using the TR Band with regard to bleeding complications, vessel occlusion and early patient discharge. Methods: We compared two successive all-comer groups (n=331 and n=324) of patients after transradial coronary procedures between 1 October 2010 and 31 March 2011. The first group underwent compression of the puncture site for 1 hour before pressure was gradually released whereas pressure was maintained for 4 hours in the second group. Results: No major access site complications occurred in either group. The rate of minor bleeding was higher after short compression compared with prolonged compression (34 (10.3%) vs 16 (4.9%), P=0.015). Short compression, female sex and use of tirofiban were associated with bleeding complications. Rates of patent pulse of the radial artery and oxygen saturation of the ipsilateral thumb were high, without any difference between the two groups. Discharge of elective outpatients was postponed by 3 hours using the longer compression scheme. Conclusions: Maintenance of high compression pressure over 4 hours leads to a lower frequency of bleeding.