TY - JOUR
T1 - Randomized comparison of rapid versus oximetry guided deflation of the transradial-band after coronary angiography or angioplasty
AU - Aagren Nielsen, Christel Gry
AU - Rasmussen, Martin Bøhme
AU - Rhode, Pernille Thordahl
AU - Bagner, Dorte Vitt
AU - Jensen, Rebekka Vibjerg
AU - Jakobsen, Lars
AU - Støttrup, Nicolaj Brejnholt
AU - Veien, Karsten Tange
AU - Larsen, Ellen Nyholm
AU - Charlot, Mette Gitz
AU - Boesgaard, Anne Elisabeth
AU - Terkelsen, Christian Juhl
N1 - Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.
PY - 2024/11/10
Y1 - 2024/11/10
N2 - Background: Transradial access is recommended for coronary angiography and angioplasty, and is associated with fewer complications when compared to femoral access. Nevertheless, there is a risk of hematoma and radial artery occlusion (RAO), and substantial time may elapse until hemostasis is achieved. Aims: We aimed to evaluate if an oximetry-guided deflation technique compared to a traditional rapid deflation technique was associated with earlier removal of the transradial band (TR-band) and lower rates of RAO following radial coronary intervention. Methods: Between October 2018 and December 2021, we randomized 3600 patients to either traditional rapid deflation where 1/3 of volume in the TR-band was removed every 20 min and reinflated if bleeding, or oximetry-guided deflation aiming at patent hemostasis and full deflation of the TR-band after 60 min, with cross-over to traditional deflation if bleeding at the time of deflation. Results: A TR-band was applied in 3540 patients, and data on time to removal was available in 3288 (93 %) of these. The time to full deflation of the TR-band was 92 versus 74 min, P < 0.01 and the time to removal of the TR-band was 112 versus 100 min, P < 0.01 in patients randomized to traditional rapid (n = 1767) versus oximetry-guided deflation (n = 1773). The rate of RAO or sub- occlusion evaluated by oximetry after TR-band removal was 1.2 % versus 1.8 %, P = 0.16. Conclusion: Traditional rapid deflation of the TR-band with the first deflation attempt after 20 min is associated with re-bleeding and prolonged time to removal of the TR-band, as compared to a strategy where the first deflation attempt is performed after 60 min. Oximetry-guided deflation, however, was not associated with lower rates of RAO or subocclusion.
AB - Background: Transradial access is recommended for coronary angiography and angioplasty, and is associated with fewer complications when compared to femoral access. Nevertheless, there is a risk of hematoma and radial artery occlusion (RAO), and substantial time may elapse until hemostasis is achieved. Aims: We aimed to evaluate if an oximetry-guided deflation technique compared to a traditional rapid deflation technique was associated with earlier removal of the transradial band (TR-band) and lower rates of RAO following radial coronary intervention. Methods: Between October 2018 and December 2021, we randomized 3600 patients to either traditional rapid deflation where 1/3 of volume in the TR-band was removed every 20 min and reinflated if bleeding, or oximetry-guided deflation aiming at patent hemostasis and full deflation of the TR-band after 60 min, with cross-over to traditional deflation if bleeding at the time of deflation. Results: A TR-band was applied in 3540 patients, and data on time to removal was available in 3288 (93 %) of these. The time to full deflation of the TR-band was 92 versus 74 min, P < 0.01 and the time to removal of the TR-band was 112 versus 100 min, P < 0.01 in patients randomized to traditional rapid (n = 1767) versus oximetry-guided deflation (n = 1773). The rate of RAO or sub- occlusion evaluated by oximetry after TR-band removal was 1.2 % versus 1.8 %, P = 0.16. Conclusion: Traditional rapid deflation of the TR-band with the first deflation attempt after 20 min is associated with re-bleeding and prolonged time to removal of the TR-band, as compared to a strategy where the first deflation attempt is performed after 60 min. Oximetry-guided deflation, however, was not associated with lower rates of RAO or subocclusion.
KW - Access site
KW - Hemostasis time
KW - Radial
KW - Radial artery occlusion
KW - Vascular closure device
UR - http://www.scopus.com/inward/record.url?scp=85208538183&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2024.132708
DO - 10.1016/j.ijcard.2024.132708
M3 - Journal article
C2 - 39532256
SN - 0167-5273
VL - 419
SP - 132708
JO - International Journal of Cardiology
JF - International Journal of Cardiology
M1 - 132708
ER -