Rawalpindi Institute of Cardiology; Rawalpindi-Pakistan.
Shifa College of Medicine, Shifa Tameer-e-Millat University; Islamabad-Pakistan.
Anatol J Cardiol. 2021 Jun;25(6):402-406. doi: 10.14744/AnatolJCardiol.2020.34694.
Novel hemostasis strategies, including PreludeSYNC DISTAL, Merit Medical Systems, Inc. South Jordan, UT, USA (PSD) radial compression device for distal radial artery (DRA) access, have been described for radial access protocols. This study aimed to compare the safety profile of PSD and Terumo radial (TR) Band®.
This prospective interventional study was conducted on patients who underwent coronary interventions via either the DRA or forearm radial artery (FRA). Patients with an arterial diameter of <2 mm, requiring dialysis, with unstable acute coronary syndrome, failed radial cannulation, and sheath insertion were excluded. PSD and TR Band® were used for hemostasis after DRA and FRA access, respectively. The time to hemostasis and complications, including minor/major hematoma, radial artery occlusion (RAO), and neurological symptoms (after 20 days) were recorded. The mean and standard deviation were calculated for age and hemostasis duration. Frequency and percentages were calculated for categorical variables. Independent t-test and Chi-squared test were performed to determine the significance of the differences between the two groups. A p-value of <0.05 was significant.
Of 139 participants, TR Band® and PSD were used in 76 and 63 patients, respectively. The mean age of the participants was 58.70±10.00 years, and the majority of the patients were men (67.60%). The hemostasis time of both devices was similar (p>0.490). Compared with PSD, TR Band® had more complications (52.63% vs. 23.81%; p=0.020), particularly RAO [odds ratio (OR), 3.17; p=0.018] and neurological problems (OR, 5.33; p=0.005).
Although, PSD seems safer in patients with coronary interventions, the device should further be explored in crossover trials for the two access types to determine the overall safety profile.
Novel 止血策略,包括 PreludeSYNC DISTAL,Merit Medical Systems,Inc.,美国犹他州南约旦(PSD)桡动脉远端(DRA)压迫装置,已被用于桡动脉入路方案。本研究旨在比较 PSD 和 Terumo 桡动脉(TR)Band®的安全性。
这是一项前瞻性介入研究,纳入了通过 DRA 或前臂桡动脉(FRA)进行冠状动脉介入的患者。排除了动脉直径<2mm、需要透析、不稳定急性冠状动脉综合征、桡动脉穿刺失败和鞘管插入的患者。PSD 和 TR Band®分别用于 DRA 和 FRA 入路后的止血。记录止血时间和并发症,包括小/大出血、桡动脉闭塞(RAO)和神经症状(20 天后)。年龄和止血时间的平均值和标准差进行计算。分类变量的频率和百分比进行计算。独立 t 检验和卡方检验用于确定两组间差异的显著性。p 值<0.05 有统计学意义。
139 名参与者中,76 名患者使用 TR Band®,63 名患者使用 PSD。参与者的平均年龄为 58.70±10.00 岁,大多数患者为男性(67.60%)。两种装置的止血时间相似(p>0.490)。与 PSD 相比,TR Band®的并发症更多(52.63% vs. 23.81%;p=0.020),尤其是 RAO[比值比(OR),3.17;p=0.018]和神经问题(OR,5.33;p=0.005)。
虽然 PSD 似乎在接受冠状动脉介入治疗的患者中更安全,但应在两种入路类型的交叉试验中进一步探索该设备,以确定总体安全性。