Instituto de Cardiologia de Santa Catarina, Rua Adolfo Donato da Silva, s/n. Praia Comprida, São José, Santa Catarina. CEP 88103-901.
J Invasive Cardiol. 2020 Apr;32(4):147-152. doi: 10.25270/jic/19.00372. Epub 2020 Mar 11.
The aim of this study was to compare two hemostatic techniques, minimum pressure technique and patent hemostasis, on radial artery occlusion (RAO) after transradial catheterization.
RAO is an infrequent complication of transradial procedures. One of the strategies used to reduce this complication is the patent hemostasis technique. Use of minimum pressure in hemostatic wristband, without monitoring patency, might have the same efficacy for preventing RAO.
This is a multicenter study encompassing patients submitted to transradial catheterization. After pneumatic wristband application, the band was deflated to the lowest allowable volume while preserving hemostasis. Radial artery patency was subsequently evaluated. The group with no return of plethysmographic curve was labeled "minimum pressure," and the group in which the signal returned was labeled "patent hemostasis." RAO was verified by Doppler evaluation within the first 24 hours of the procedure.
A total of 1082 patients were enrolled, with mean age of 61.4 ± 10.4 years. The majority (61.0%) were male and 34.5% had diabetes. Patent hemostasis was achieved in only 213 cases (20%). Early RAO occurred in 16 patients (1.8%) in the minimum pressure group and in 4 patients (1.9%) in the patent hemostasis group (P=.97). No major bleeding was observed among the entire cohort. EASY scale for hematoma grade was similar between the cohorts (EASY grades 1-3: 7.0% in the minimum pressure group vs 7.5% in the patent hemostasis group; P=.96).
Checking radial patency during hemostatic compression may not be necessary after the procedure when adopting a mild and short hemostatic compression.
本研究旨在比较两种止血技术，即最小压力技术和专利止血技术，对经桡动脉穿刺后桡动脉闭塞（RAO）的影响。
RAO 是经桡动脉介入治疗的一种罕见并发症。减少这种并发症的策略之一是专利止血技术。在止血腕带中使用最小压力，而不监测通畅性，可能同样有效预防 RAO。
这是一项多中心研究，纳入了接受经桡动脉导管插入术的患者。气动腕带应用后，在保持止血的同时将腕带放气至最低允许体积。随后评估桡动脉通畅性。无容积描记曲线恢复的组标记为“最小压力”，信号恢复的组标记为“专利止血”。在操作后的 24 小时内通过多普勒评估验证 RAO。
共纳入 1082 例患者，平均年龄为 61.4 ± 10.4 岁。大多数（61.0%）为男性，34.5%患有糖尿病。仅 213 例（20%）实现了专利止血。最小压力组中有 16 例（1.8%）和专利止血组中有 4 例（1.9%）发生早期 RAO（P=.97）。整个队列中均未观察到大出血。两组的 EASY 血肿分级相似（EASY 分级 1-3：最小压力组为 7.0%，专利止血组为 7.5%；P=.96）。
在采用轻度和短暂的止血压迫时，在止血过程中检查桡动脉通畅性可能不是必需的。
