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To compare the safety and efficacy of an expedited protocol with the standard protocol for deflation of the TR Band (Terumo) for radial artery access hemostasis. 30 patients undergoing intra-arterial therapy (radioembolization, uterine fibroid embolization) via trans-radial approach were randomized to standard or expedited deflation protocol. These patients were analyzed over the course of 18 months. The standard protocol requires band inflation for 60 minutes, followed by removal of 3-5 mL every 15 minutes over the next 60 minutes. The expedited protocol eliminated the initial 60-minute waiting period, and 3-5 mL of air was removed every 15 minutes over 60 minutes. If bleeding occurred, air was reinserted, and deflation was reattempted in 15-30 minutes. 13 patients underwent the standard protocol, and 17 patients underwent the expedited protocol. There were no differences between the two groups regarding demographics, co-morbidities, or coagulation parameters. Safety was analyzed based on the incidence of complications, including bleeding and bruising. The patency of the left radial artery was accounted for by ultrasound in most patients. Efficacy was determined by successful hemostasis at discharge. There was one complication in each group (mild bruising in the expedited group and mild bleeding in the standard group). A chi-square test of independence revealed no significant difference between the standard and expedited protocols in terms of complications (chi-squared value of 0.0388 and p-value of 0.8438). All patients examined with ultrasound for radial artery patency were found to have patent left radial arteries. Appropriate hemostasis was achieved in all patients. The expedited deflation protocol using the TR band (Terumo) was as safe and effective as the standard protocol for radial artery hemostasis. The use of an expedited process can increase hospital efficiency. Further studies using larger population sizes are required to increase the power of the study.
Nicodemus et al. (Wed,) studied this question.