Ognerubov D V, Provatorov S I, Tereshchenko A S, Romasov I V, Pogorelova O A, Tripoten M I, Balakhonova T V, Merkulov E V, Samko A N
National Medical Research Center for Cardiology.
Kardiologiia. 2019 Jan 28;59(1):79-83. doi: 10.18087/cardio.2019.1.10218.
to compare rates of access site complications at early (after 4 hours) and traditional (after 24 hours) removal of a compression bandage after diagnostic transradial (TR) coronary angiography (CA) in patients not receiving anticoagulants.
We included into this study 392 patients (mean age 63±8.7 years, 62.8% men) who underwent transradial coronary angiography. Patients were divided into 2 groups. In group 1 patients (n=221) compression bandage was removed from puncture site in 4 hours after procedure with subsequent control of radial artery patency using presence of pulse metric curve during ulnar artery compression (the reverse Barbeau test with pulse oximeter). In patients of group 2 (n=171) compression band was removed after 24 hours. In both groups control of radial artery patency was carried out after 24 hours using the reverse Barbeau test. Upon detection of radial artery occlusion (RAO) ultrasound imaging of the forearm arteries was performed.
No RAO was detected in group 1 while in group 2 number of detected RAO was 15 (8.8%) (р<0.05). Rates of hematomas at puncture site were not significantly different. Puncture site bleeding after band removal requiring repeated banding occurred in 1 patient of group one (0.6%); no such cases were registered in group 2 (p>0.05).
Compared with traditional method early removal of compression bandage after TR CA was associated with lower rate of RAO.
比较在未接受抗凝治疗的患者中，诊断性经桡动脉（TR）冠状动脉造影（CA）后早期（4小时后）和传统（24小时后）去除压迫绷带时穿刺部位并发症的发生率。
本研究纳入392例行经桡动脉冠状动脉造影的患者（平均年龄63±8.7岁，男性占62.8%）。患者分为2组。第1组患者（n = 221）在术后4小时从穿刺部位去除压迫绷带，随后在压迫尺动脉时通过脉搏测量曲线的存在情况（使用脉搏血氧仪的反向巴博试验）来控制桡动脉通畅情况。第2组患者（n = 171）在24小时后去除压迫绷带。两组均在24小时后使用反向巴博试验控制桡动脉通畅情况。一旦检测到桡动脉闭塞（RAO），则对前臂动脉进行超声成像检查。
第1组未检测到RAO，而第2组检测到的RAO数量为15例（8.8%）（p<0.05）。穿刺部位血肿的发生率无显著差异。第1组有1例患者（0.6%）在去除绷带后穿刺部位出血，需要重新包扎绷带；第2组未记录到此类病例（p>0.05）。
与传统方法相比，TR CA后早期去除压迫绷带与较低的RAO发生率相关。
