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Safety and Efficacy of a Truncated Deflation Algorithm for Distal Transradial Access
Anastasia Hadjivassiliou1, Leandro Cardarelli-Leite1, Sabeena Jalal1
1Department of Radiology, Vancouver General Hospital, 899 West 12th Avenue, Vancouver, BC V5Z 1M9, Canada.
Purpose:
To assess safety and efficacy of a modified rapid hemostasis protocol for distal transradial access (TRA).
Materials And Methods:
A single-center retrospective study of patients undergoing percutaneous image-guided procedures from a distal TRA with rapid deflation hemostasis protocol was performed. Between March 2017 and August 2019, 593 procedures in 434 patients were performed. Mean patient age was 63.5 y (range, 18-94 y).
Results:
The most common procedures were transarterial chemoembolization (218; 36.8%), abdominal and pelvic embolization (116; 19.6%), yttrium-90 mapping (115; 19.4%), yttrium-90 administration (84; 14.2%), and diagnostic angiography (44; 7.4%). Mean (range) values for clotting parameters were international normalized ratio 1.2 (0.9-3.2), partial thromboplastin time 33.5 s (26-44 s), and platelets 23.4 × 109/L (37-552 × 109/L). A hematoma developed in 7 (1.2%) patients. No radial artery occlusions were encountered during follow-up. Nursing intensity was defined as the number of minutes after the procedure required for assessing and managing the access site for bleeding. The mean nursing intensity was 25.1 min (range, 25-40 min).
Conclusions:
The rapid deflation hemostasis protocol for distal TRA at the anatomical snuffbox was feasible and safe. No significant difference or association was found between hematoma formation and clotting parameters after the procedure or type of vascular access equipment used.
