Dai Neng, Xu Da-chun, Hou Lei, Peng Wen-hui, Wei Yi-dong, Xu Ya-wei
Neng Dai, PhD Fellow, Medical College, Tongji University, Shanghai, China. Da-chun Xu, MD, PhD Attending Doctor, Department of Cardiology, Tenth People's Hospital, Tongji University, Shanghai, China. Lei Hou, MD, PhD Associate Professor, Department of Cardiology, Tenth People's Hospital, Tongji University, Shanghai, China. Wen-hui Peng, MD, PhD Attending Doctor, Department of Cardiology, Tenth People's Hospital, Tongji University, Shanghai, China. Yi-dong Wei, MD, PhD Associate Professor, Department of Cardiology, Tenth People's Hospital, Tongji University, Shanghai, China. Ya-Wei Xu, MD, PhD Professor, Department of Cardiology, Tenth People's Hospital, Tongji University, Shanghai, China.
J Cardiovasc Nurs. 2015 May-Jun;30(3):192-6. doi: 10.1097/JCN.0000000000000115.
Transradial access is an attractive approach for angiography or percutaneous coronary intervention. Different devices have been used to apply pressure locally at the site of arterial entry for achieving hemostasis. The aim of this study was to evaluate the effect of 2 different hemostatic devices on radial artery outcomes after transradial coronary intervention.
This study included 600 patients who had undergone transradial coronary intervention who were randomized into 2 groups after the procedure: 300 were treated with a radial compression device (TR Band, Terumo Medical, Tokyo, Japan) (CD group) and the other 300 patients were treated using a chitosan-based pad (Anscare, Daxon, Taoyuan, Taiwan) (CS group). Compression time, major and minor access site bleeding complications, and incidence of radial artery occlusion were recorded.
There were no statistical differences in the baseline clinical characteristics of the patients between the 2 groups. Compression time in the CS group was significantly shorter than that in the CD group (P < .001). Although no major access site bleeding complications were observed in either group, 6 patients in each group experienced minor access site bleeding complications. At the same time, 61 patients in the CD group and 21 patients in the CS group experienced errhysis (20% vs 7%, respectively; P < .001). Early radial artery occlusion (24 hours) occurred in 11.7% of the patients in the CD group and 5.4% of the patients in the CS group (P < .05). Chronic radial artery occlusion (30 days) occurred in 10% of the patients in the CD group and 5% of the patients in the CS group (P < .05).
The application of the chitosan-based pad showed better hemostatic efficacy and a lower incidence of radial artery occlusion after transradial coronary intervention compared with the compression device.
经桡动脉途径用于血管造影或经皮冠状动脉介入治疗具有吸引力。已使用不同装置在动脉穿刺部位局部施加压力以实现止血。本研究的目的是评估两种不同止血装置对经桡动脉冠状动脉介入治疗后桡动脉结局的影响。
本研究纳入600例行经桡动脉冠状动脉介入治疗的患者，术后随机分为两组：300例接受桡动脉压迫装置（TR Band，泰尔茂医疗，日本东京）治疗（CD组），另外300例患者使用基于壳聚糖的垫子（安赛瑞，达信，台湾桃园）治疗（CS组）。记录压迫时间、主要和次要穿刺部位出血并发症以及桡动脉闭塞发生率。
两组患者的基线临床特征无统计学差异。CS组的压迫时间明显短于CD组（P < 0.001）。虽然两组均未观察到主要穿刺部位出血并发症，但每组有6例患者出现次要穿刺部位出血并发症。同时，CD组有61例患者出现渗血，CS组有21例患者出现渗血（分别为20%对7%；P < 0.001）。CD组11.7%的患者发生早期桡动脉闭塞（24小时内），CS组5.4%的患者发生早期桡动脉闭塞（P < 0.05）。CD组10%的患者发生慢性桡动脉闭塞（30天），CS组5%的患者发生慢性桡动脉闭塞（P < 0.05）。
与压迫装置相比，基于壳聚糖的垫子在经桡动脉冠状动脉介入治疗后显示出更好的止血效果和更低的桡动脉闭塞发生率。
