Impact of radial compression protocols on radial artery occlusion and hemostasis time in coronary angiography

Area of Science:

• Cardiology
• Vascular Surgery
• Interventional Radiology

Background:

• Hemostasis protocols after trans-radial approach (TRA) lack standardization, leading to varied clinical practices.
• Current methods for achieving hemostasis post-TRA often result in prolonged compression times and potential complications.

Purpose of the Study:

• To evaluate the clinical implications of a novel, evidence-based radial compression protocol for hemostasis after TRA.
• To compare the efficacy and safety of the new protocol against traditional methods in an outpatient setting.

Main Methods:

• A comparative study involving 1842 patients undergoing invasive catheter angiography via TRA.
• Patients were divided into two groups: traditional (n=1001) and new (n=841) radial compression protocols.
• The new protocol involved air removal every 30 minutes, contrasting with the traditional protocol's fixed deflation times.

Main Results:

• The new protocol group demonstrated a significantly lower rate of dual antiplatelet therapy use (24% vs. 35%).
• Complete hemostasis time was reduced by approximately two-thirds with the new protocol (66 min vs. 190 min).
• Radial artery occlusion (RAO) incidence decreased dramatically from 9.8% in the traditional group to 0.9% in the new protocol group (p<0.001).

Conclusions:

• The new radial compression protocol significantly shortens hemostasis duration following TRA.
• This optimized protocol is strongly associated with a substantially lower incidence of radial artery occlusion.
• The findings support the adoption of this new protocol for improved patient safety and efficiency in TRA procedures.