Pancholy Samir B
Department of Cardiology, Mercy Hospital and Community Medical Center, Scranton, Pennsylvania, USA.
J Invasive Cardiol. 2009 Mar;21(3):101-4.
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.
我们的目的是评估两种不同止血装置对经桡动脉导管插入术后桡动脉结局的影响。
桡动脉闭塞是经桡动脉穿刺的一种少见但令人沮丧的并发症。它与鞘管与动脉比例等因素有关，肝素的使用可降低其发生率。它通常不会导致缺血性并发症，但会妨碍未来的经桡动脉穿刺。
500例连续接受经桡动脉导管插入术的患者被前瞻性纳入本研究。250例连续患者通过应用HemoBand进行止血（第一组），接下来的250例患者使用可充气的TR Band进行止血（第二组）。在应用止血装置时、30分钟、60分钟、24小时和30天时，使用Barbeau试验研究桡动脉通畅情况。
第一组有28例患者（11.2%）出现早期闭塞（24小时时），而第二组有11例患者（4.4%）出现早期闭塞（p<0.005）。第一组有18例患者（7.2%）出现慢性闭塞证据（30天时），而第二组有8例患者（3.2%）出现慢性闭塞证据（p<0.05）。与使用HemoBand的第一组相比，使用TR Band的第二组更频繁地出现早期（30分钟）通畅恢复（75%对24%；p<0.001），这可能与TR Band气室压力在早期（30分钟）显著降低有关。两组均未发生明显出血并发症。
与HemoBand相比，使用TR Band止血时桡动脉闭塞显著减少，且不影响止血效果。
