J Transcat Intervent.2018;26:a0004.
Randomized comparison of hemostasis times after radial access for cardiac catheterization
DOI: 10.31160/JOTCI2018;26(1)A0004
ABSTRACT
Background
Radial access has been widely used in percutaneous coronary procedures. Occlusion of the radial artery is the most important vascular complication related to the duration of compression time after radial access for cardiac catheterization. The objective of this study was to compare the efficacy and safety of hemostasis for 2 or 3 hours after diagnostic cardiac catheterization via radial approach.
Methods
A prospective, randomized study with 206 patients recruited after cardiac catheterization using radial access, between November 2014 and November 2015.
Results
There was no difference in vascular complications between the 2 and 3-Hour Groups. After the procedure, active bleeding during hemostasis occurred in 24 patients (9.7% vs. 13.6%; p=0.385). Clinical evaluation after 7 days found history of pain in 41 (19.9%), and hematoma in 48 patients (28.3 vs. 20.0; p=0.172), with higher frequency of hematomas smaller than 10cm (50.0% vs. 60.0%; p=0.679). Evaluation by ultrasound found flow reduction in 4 patients (2.0% vs. 2.0%; p=0.698), occlusion in 18 (7.7% vs. 11%; p=0.334), subcutaneous hematoma in 2 (2.0% vs. 0.0%; p=0.246), subcutaneous edema in 2 (1.0% vs. 1.0%; p>0.99), arterial dissection in 2 (1.0% vs. 1.0%; p>0.99), and pseudoaneurysm in 1 (0.0% vs. 1.0%; p>0.99).
Conclusions
Reducing compression time of the radial artery to 2 hours during hemostasis in invasive diagnostic coronary procedures has been proved safe and effective. Compared to the 3-hour period, it demonstrated similar rates of vascular complications.
Keywords: Cardiac catheterization; Hemostasis; Radial artery
621