J Transcat Intervent. 10/Oct/2018;26(1-2):eA0015.
Comparison between compression dressing and hemostatic wristband after cardiac procedures using the radial approach
The radial approach for cardiac catheterization and coronary angioplasty is well established. The prevalence of radial artery occlusion and its determining factors still raises debate. The objective of this study was to analyze the incidence of radial artery occlusion after cardiac procedures using the radial approach, comparing hemostasis done by elastic compression dressing or hemostatic wristband.
A randomized clinical trial comparing the incidence of radial artery occlusion as established by palpation and vascular Doppler, upon discharge and at 30-day follow-up, in patients submitted to cardiac procedures using the radial approach, assigned to hemostasis by elastic dressing or hemostatic wristband.
A total of 190 patients were included, 166 completed the 30-day follow-up. There were no differences in baseline characteristics between the groups. The incidence of radial occlusion at hospital discharge, with elastic bandage or hemostatic wristband as verified by palpation and arterial Doppler was, respectively, 9.7% vs. 12.4%, and 6.5% vs. 10.3%, with no difference between groups. At 30-day follow-up, it was 11.8% vs. 18.9% and 10.5% vs. 16.5%, with no difference between groups. No reduction in the incidence of arterial occlusion was noted with the use of high-dose heparin, although patients undergoing cardiac catheterization presented radial occlusion more frequently than those submitted to percutaneous coronary intervention.
The radial artery patency of the compression dressing upon hospital discharge and at 30 days was similar to that of the hemostatic wristband.