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Protamine-Facilitated Same-Day Discharge Following Distal Transradial Angiography.

Chen Yan1, Tang Yang2, Gao Li-Jian1

  • 1Department of Cardiology, The State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|July 30, 2025
PubMed
Summary
This summary is machine-generated.

Same-day discharge after distal transradial approach (dTRA) coronary angiography (CAG) using protamine is safe and feasible. This method significantly reduces hemostasis time and hospital costs compared to standard transradial approach (sTRA).

Keywords:
coronary angiographydistal transradial approachprotaminesame‐day discharge

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Area of Science:

  • Cardiology
  • Vascular Access Procedures
  • Interventional Cardiology

Background:

  • Distal transradial approach (dTRA) adoption is increasing, but data on same-day discharge with protamine-assisted hemostasis after coronary angiography (CAG) is limited.
  • This pilot study evaluates the safety and feasibility of same-day discharge following CAG via dTRA with protamine.
  • The study compares dTRA with standard transradial approach (sTRA) in terms of hemostasis, cost, and procedure duration.

Purpose of the Study:

  • To investigate the safety and feasibility of same-day discharge after coronary angiography (CAG) using the distal transradial approach (dTRA) with protamine-assisted hemostasis.
  • To compare the efficacy of dTRA with standard transradial approach (sTRA) regarding time to hemostasis, procedure duration, and hospital costs.
  • To assess bleeding-related complications and radial artery occlusion rates associated with dTRA.

Main Methods:

  • A pilot study included 34 patients undergoing elective CAG via dTRA with same-day discharge and protamine administration.
  • A matched cohort of 34 patients undergoing CAG via sTRA was used for comparison.
  • Primary endpoint was time to hemostasis; secondary endpoints included costs, procedure duration, and safety (bleeding complications). Multivariable regression analyzed correlations.

Main Results:

  • Coronary angiography (CAG) with a 6F sheath was successful in all patients in both distal transradial approach (dTRA) and standard transradial approach (sTRA) groups.
  • dTRA group showed significantly shorter hemostasis time (1.3h vs. 5.9h) and lower hospital costs (p<0.020) compared to sTRA.
  • No significant difference in procedure duration or bleeding complications was observed; radial artery occlusion occurred in 2 dTRA and 3 sTRA patients.

Conclusions:

  • Same-day discharge following coronary angiography (CAG) via distal transradial approach (dTRA) with protamine is a safe and feasible strategy.
  • dTRA significantly reduces hemostasis time and hospital costs compared to the standard transradial approach (sTRA).
  • Further research may be warranted, although this observational cohort was not prospectively registered.