Pressure-guided pneumatic radial compression and radial artery occlusion after transradial coronary procedures: a retrospective historical cohort study

Objectives To evaluate a pressure-measured pneumatic radial compression protocol and its association with radial artery occlusion (RAO) after transradial coronary procedures.Design This single-center retrospective historical cohort included 514 consecutive patients treated between February and December 2025. The control group received conventional screw-type compression with clinically guided staged adjustment (n = 260), whereas the observation group received pneumatic compression with quantitative pressure measurement and individualized staged adjustment (n = 254). The primary outcome was RAO at 24 hours; RAO at 7 days and other clinical outcomes were secondary outcomes.Results The observation group had lower observed RAO rates than the control group at 24 hours [2.8% (7/254) vs. 7.7% (20/260), P = 0.012] and 7 days [2.0% (5/254) vs. 5.4% (14/260), P = 0.040]. After Firth penalized logistic regression, the protocol remained associated with lower odds of RAO at 24 hours (adjusted OR = 0.358, 95% CI: 0.143–0.809; P = 0.013). The observation group also had lower pain scores at 6 and 24 hours (both P < 0.001), higher digital SpO2 values at 2, 4, and 24 hours (all P < 0.001), higher primary hemostatic success [97.2% vs. 93.5%, P = 0.042], and fewer patients with puncture-site oozing [2.8% vs. 6.9%, P = 0.028] or at least one local complication [11.4% vs. 28.1%, P < 0.001].Conclusions Pressure-guided pneumatic compression was associated with lower observed RAO rates and more favorable hemostatic and local outcomes than conventional screw-type compression.