Manual versus mechanical compression hemostasis approach after coronary angiography via snuffbox access

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Access

Background:

• Trans-snuffbox access (TSA) is an emerging technique for coronary artery interventions.
• Ensuring effective vascular hemostasis after TSA remains a key consideration.

Purpose of the Study:

• To compare the efficacy of manual compression versus mechanical compression (TR band) for vascular hemostasis following TSA.
• To evaluate patient satisfaction, pain, hospitalization, and neurovascular complications associated with each hemostasis method.

Main Methods:

• A prospective, nonrandomized clinical trial involving 80 patients undergoing diagnostic coronary angiography (CAG) via TSA.
• Patients were divided into two groups: manual compression and mechanical compression.
• Primary endpoint was primary hemostasis time; secondary endpoints included patient satisfaction, pain, hospitalization, and complications.

Main Results:

• Manual compression resulted in a significantly shorter primary hemostasis time (15.0±5.9 min) compared to the TR band (25.7±4.9 min) (p<0.001).
• No significant differences were observed in patient satisfaction, pain severity, hospitalization time, or rates of neurovascular complications between the groups.
• Key complications like hematoma, numbness, and radial artery occlusion showed no significant difference.

Conclusions:

• Manual compression is a superior method for reducing hemostasis time in patients undergoing CAG via TSA.
• The findings suggest manual compression is a more efficient approach for achieving hemostasis in TSA procedures compared to mechanical compression.