Yang Yanru, Zhu Hongyan, Zai Guangyao
Department of Cardiovascular Medicine, Capital Medical University, Beijing LuHe Hospital, Beijing, China.
Front Cardiovasc Med. 2025 Jan 15;11:1412479. doi: 10.3389/fcvm.2024.1412479. eCollection 2024.
This meta-analysis elucidates the efficacy of the Transradial Band Device (TR Band) in minimizing complications like radial artery occlusion and hematoma, preserving heart health, and enhancing blood flow post-transradial catheterization.
A comprehensive literature search across databases including PubMed, Cochrane, and Embase examined the impact of radial artery compression techniques and decompression times on complications. Data from 13 studies were analyzed using R 4.1.2 with fixed-effects and random-effects models. The Newcastle-Ottawa Scale assessed the risk of bias in observational cohort studies.
In our meta-analysis, we evaluated data from various studies encompassing different air volumes in transradial band devices across several outcomes including bleeding, hematoma, radial artery occlusion (RAO), Visual Analog Scale (VAS) scores, and compression time. The collective analysis integrated findings from 11 studies, totaling 4,679 patients. No significant difference in bleeding risk (OR 1.04, 95% CI 0.60-1.82, > 0.05, = 78%), hematoma incidence (OR 0.96, 95% CI 0.78-1.19, > 0.05, = 0%), or RAO incidence (OR 0.96, 95% CI 0.78-1.19, > 0.05, = 0%) was observed between the "Less air" and "15 ml air" groups. However, the "Less air" group reported significantly higher VAS scores indicating increased pain or discomfort (Mean Difference 0.25, 95% CI 0.09-0.41, < 0.05, = 0%). Compression time analyses showed no significant difference between groups (Mean Difference -17.73, 95% CI -54.65-19.20, > 0.05, = 99%). Sensitivity analyses confirmed the stability of these findings, and Egger's test indicated no significant publication bias across the outcomes. This synthesis highlights the nuanced impact of air volume adjustments in transradial bands on patient outcomes, emphasizing the necessity for further research and standardized protocols to optimize patient safety and comfort post-intervention.
The TR Band, when utilized with optimized air volume/pressure, maintains an essential balance between ensuring hemostasis and enhancing patient comfort without elevating the risk of radial artery complications. These findings support the careful selection of TR Band settings to optimize clinical outcomes in patients undergoing transradial cardiac procedures. Further research is warranted to establish standardized guidelines for the most effective use of TR Band in various clinical scenarios.
本荟萃分析旨在阐明经桡动脉束带装置（TR Band）在减少诸如桡动脉闭塞和血肿等并发症、保护心脏健康以及增强经桡动脉导管插入术后血流方面的疗效。
通过对包括PubMed、Cochrane和Embase在内的数据库进行全面文献检索，研究桡动脉压迫技术和减压时间对并发症的影响。使用R 4.1.2软件，采用固定效应模型和随机效应模型对13项研究的数据进行分析。纽卡斯尔-渥太华量表评估观察性队列研究中的偏倚风险。
在我们的荟萃分析中，我们评估了来自各项研究的数据，这些研究涉及经桡动脉束带装置中不同空气量的多种结局，包括出血、血肿、桡动脉闭塞（RAO）、视觉模拟评分（VAS）以及压迫时间。汇总分析整合了11项研究的结果，共计4679例患者。“较少空气量”组和“15毫升空气量”组在出血风险（比值比1.04，95%置信区间0.60 - 1.82，P＞0.05，I² = 78%）、血肿发生率（比值比0.96，95%置信区间0.78 - 1.19，P＞0.05，I² = 0%）或RAO发生率（比值比0.96，95%置信区间0.78 - 1.19，P＞0.05，I² = 0%）方面未观察到显著差异。然而，“较少空气量”组报告的VAS评分显著更高，表明疼痛或不适增加（平均差值0.25，95%置信区间0.09 - 0.41，P＜0.05，I² = 0%）。压迫时间分析显示组间无显著差异（平均差值 - 17.73，95%置信区间 - 54.65 - 19.20，P＞0.05，I² = 99%）。敏感性分析证实了这些结果的稳定性，Egger检验表明各结局均无显著的发表偏倚。这一综合分析突出了经桡动脉束带中空气量调整对患者结局的细微影响，强调了进一步研究和制定标准化方案以优化干预后患者安全性和舒适度的必要性。
当以优化的空气量/压力使用TR Band时，在确保止血和提高患者舒适度之间保持了关键平衡，而不会增加桡动脉并发症的风险。这些发现支持在经桡动脉心脏手术患者中谨慎选择TR Band设置以优化临床结局。有必要进行进一步研究以建立在各种临床场景中最有效使用TR Band的标准化指南。
