Author + information
- Kintur Sanghvi,
- Jeff Stahl,
- Nha Huynh and
- Antonio Christophy
Asymptomatic radial artery occlusion (RAO) is a major limitation of transradial catheterization (TRC). Two radial compression hemostatic devices are compared for their effect on RAO.
During 2016 in a prospective, randomized, single-center, blinded trial, 320 patients were randomly treated with a TR band (Terumo Corporation) or Safeguard Radial (Merit Medical). Institution-wide protocols consisting of anticoagulation, patent hemostasis, duration of compression, and use of 6 Fr slender sheaths (Terumo Corporation) were observed. Discomfort related to the device was recorded using the universal pain scale. Radial artery patency was evaluated by reverse Barbeau’s test prior to discharge (1 hr post diagnostic and 6-24 hrs post-intervention) and at 30-days.
Of the 320 patients, 155 were randomized to the TR group (TRG) and 159 to the Safeguard group (SGG), and 6 were excluded due to access failure. Demographic and procedural characteristics were similar with the exception of the type of procedure (Table). Both bands were equally effective in achieving patent hemostasis. Despite having a higher rate of post-procedure hematoma (1.29% TRG vs. 3.1% SGG, p = 0.04) and acute RAO (3.8% TRG vs. 6.28% SGG, p = 0.05) with the Safeguard band, at 30 days RAO was similar in both groups (1.9% TRG vs. 2.5% SGG; p = 0.21). Patients in the SGG reported significantly lower discomfort and were found to require less air to achieve patent hemostasis (Table).
Evidence-based contemporary transradial catheterization protocols of using smaller diameter access sheath, anticoagulation, and use of just enough pressure for the shortest duration of time to achieve hemostasis is associated with very low RAO rate at 30 days irrespective of the brand of radial compression device used.