Effect of duration of hemostatic compression on radial artery occlusion after transradial access.

OBJECTIVES

To evaluate the effect of duration of hemostatic compression on the incidence of radial artery occlusion (RAO) after transradial coronary intervention.

BACKGROUND

RAO occurs in 2-10% of patients after transradial access. The effect of duration of hemostatic compression on occurrence of RAO is unknown.

METHODS

Four hundred consecutive patients undergoing transradial coronary intervention were retrospectively analyzed. Group I (n = 200) patients received hemostatic compression for 6 hr after completion of the procedure, and group II (n = 200) patients for 2 hr after completion of the procedure. TR band was used for hemostasis. Demographic and procedural variables as well as early (24 hr) and chronic (30 days) RAO as well as bleeding events were recorded.

RESULTS

Demographic as well as procedural variables were similar between group I and group II. Early radial artery occlusion (ERAO) occurred in 12% of patients in group I and 5.5% of patients in group II, the difference was statistically significant (P = 0.025). Chronic radial artery occlusion (CRAO) occurred in 8.5% of patients in group I and 3.5% of patients in group II, the difference was statistically significant (P = 0.035). Occlusive compression was the only independent predictor of radial artery occlusion [Odds ratio = 13.1, P = 0.001]. Two patients in group I and one in group II developed small hematoma (P = 0.161).

CONCLUSIONS

Shorter duration of hemostatic compression is associated with a lower incidence of early and chronic RAO, without increase in bleeding complications, although maintaining radial patency during hemostatic compression, eliminates the adverse effect of duration of compression.