Roberts Jonathan S, Niu Jianli, Pastor-Cervantes Juan A
Memorial Regional Hospital, Memorial Cardiac and Vascular Institute, Memorial Healthcare System, Hollywood, FL 33021, USA.
Memorial Regional Hospital, Memorial Cardiac and Vascular Institute, Memorial Healthcare System, Hollywood, FL 33021, USA.
Cardiovasc Revasc Med. 2019 Oct;20(10):871-874. doi: 10.1016/j.carrev.2018.11.026. Epub 2018 Dec 6.
Hemostasis following transradial arterial access (TRA) is usually achieved by mechanical compression. This study investigated if use of a chitosan-based hemostatic pad (Clo-Sur Radial™) combined with mechanical compression (TR Band®) could shorten hemostasis time after TRA, compared with a TR Band® alone.
40 patients undergoing cardiac catheterization and/or percutaneous coronary intervention were assigned into 4 cohorts post TRA: 10 patients received mechanical compression with a TR Band® alone for 120 min. The other 30 patients received compression with a Clo-Sur Radial™ pad combined with a TR Band® for 60 min, 45 min, and 30 min, respectively (n = 10/per cohort). Times to hemostasis and access-site complications were recorded.
There were no differences in patient characteristics, mean dose of heparin, or mean activated clotting time value at the end of procedure among the four cohorts. Median time to hemostasis with the TR Band® alone was 120.5 min versus 60 min, 45 min and 30 min for the 60-min, 45-min, and 30-min Clo-Sur Radial™ pad combined with the TR Band® cohorts, respectively. No radial artery occlusion, late rebleeding nor hematoma was noted in this series of patients.
In this pilot trial, use of a Clo-Sur Radial™ pad in combination with a TR band® significantly shortened hemostasis time, as compared to a TR band® alone, with no increased complications noted.
经桡动脉穿刺(TRA)后的止血通常通过机械压迫来实现。本研究调查了与单独使用TR Band®相比,使用基于壳聚糖的止血垫(Clo-Sur Radial™)联合机械压迫(TR Band®)是否能缩短TRA后的止血时间。
40例行心脏导管插入术和/或经皮冠状动脉介入治疗的患者在TRA后被分为4组:10例患者仅接受TR Band®机械压迫120分钟。其他30例患者分别接受Clo-Sur Radial™垫联合TR Band®压迫60分钟、45分钟和30分钟(每组n = 10)。记录止血时间和穿刺部位并发症。
四组患者的特征、肝素平均剂量或手术结束时的平均活化凝血时间值均无差异。单独使用TR Band®的中位止血时间为120.5分钟,而60分钟、45分钟和30分钟Clo-Sur Radial™垫联合TR Band®组分别为60分钟、45分钟和30分钟。该系列患者未发现桡动脉闭塞、迟发性再出血或血肿。
在这项初步试验中,与单独使用TR Band®相比,Clo-Sur Radial™垫联合TR Band®显著缩短了止血时间,且未发现并发症增加。