Impact of two different hemostatic devices on radial artery outcomes after transradial catheterization

Our objective was to evaluate the effectof two different hemostatic devices on radial artery outcomes after transradial catheterization.

Radial artery occlusion is an infrequent but discouraging complication of transradial access. It is related to factors such as sheath-to-artery ratio and its incidence is decreased by the administration of heparin. It usually does not lead to ischemic complications, but precludes future transradial access.

500 consecutive patients undergoing transradial catheterization were prospectively enrolled in the study. 250 consecutive patients received hemostasis by application of the HemoBand (Group I), and the next 250 patients received hemostasis using the inflatable TR Band (Group II). Radial artery patency was studied at the time of application of the hemostasis device, at 30 minutes, 60 minutes and at 24 hours and 30 days using Barbeau's test.

28 patients in Group I (11.2%), developed early occlusion (at 24 hours), compared to 11 patients (4.4%) in Group II (p < 0.005). 18 patients in Group I (7.2%), developed evidence of chronic occlusion (at 30 days), compared to 8 patients (3.2%) in Group II (p < 0.05). Early (30 minutes) return of patency was seen more frequently in Group II using the TR Band compared to Group I using the HemoBand (75% vs. 24%; p < 0.001), probably related to a significant early (30 minutes) decrease in TR Band air-chamber pressure. No significant bleeding complication occurred in either group.

A significant reduction in radial artery occlusion was noted with hemostasis using the TR Band compared to the HemoBand, without compromising hemostatic efficacy.