Randomized Trial of Compression Duration After Transradial Cardiac Catheterization and Intervention
BackgroundRadial artery occlusion is a known complication following transradial cardiac catheterization. A shorter duration of postprocedural radial clamp time may reduce radial artery occlusion (RAO) but might be associated with incomplete hemostasis. Methods and ResultsIn total, 568 patients under...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2017-02-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.116.005029 |
| _version_ | 1818289553064067072 |
|---|---|
| author | Shahar Lavi Asim Cheema Andrew Yadegari Zeev Israeli Yaniv Levi Sabrina Wall Mistre Alemayehu Yasir Parviz Bogdan‐Dorian Murariu Terry McPherson Jaffer Syed Rodrigo Bagur |
| author_facet | Shahar Lavi Asim Cheema Andrew Yadegari Zeev Israeli Yaniv Levi Sabrina Wall Mistre Alemayehu Yasir Parviz Bogdan‐Dorian Murariu Terry McPherson Jaffer Syed Rodrigo Bagur |
| author_sort | Shahar Lavi |
| collection | DOAJ |
| description | BackgroundRadial artery occlusion is a known complication following transradial cardiac catheterization. A shorter duration of postprocedural radial clamp time may reduce radial artery occlusion (RAO) but might be associated with incomplete hemostasis. Methods and ResultsIn total, 568 patients undergoing transradial diagnostic cardiac catheterization were randomly assigned to either 20 minutes (ultrashort) or 60 minutes (short) hemostatic compression time using patent hemostasis. Subsequently, clamp pressure was reduced gradually over 20 minutes. Access site hemostasis and RAO were assessed after clamp removal. Repeated assessment of RAO was determined at 1 week in 210 (37%) patients. Mean age was 64±11 years, and 30% were female. Percutaneous coronary intervention was performed in 161 patients. RAO immediately after clamp removal was documented in 14 (4.9%) and 8 (2.8%) patients in the 20‐ and 60‐minute clamp application groups, respectively (P=0.19). The incidence of grade 1 hematoma was higher in the 20‐minute group (6.7% versus 2.5%, P=0.015). RAO at 1 week after the procedure was 2.9% and 0.9% in the 20‐ and 60‐minute groups, respectively (P=0.36). Requirement for clamp retightening (36% versus 16%, P=0.01) was higher among patients who had RAO. Need for clamp retightening was the only independent predictor of RAO (P=0.04). ConclusionsUltrashort radial clamp application of 20 minutes is not preferable to a short duration of 60 minutes. The 60‐minute clamp duration is safe and provides good access site hemostasis with low RAO rates. Clinical Trial RegistrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT02269722. |
| first_indexed | 2024-12-13T02:14:06Z |
| format | Article |
| id | doaj.art-ec35b98befc9487cb7250f69f31fce75 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-13T02:14:06Z |
| publishDate | 2017-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-ec35b98befc9487cb7250f69f31fce752022-12-22T00:02:57ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802017-02-016210.1161/JAHA.116.005029Randomized Trial of Compression Duration After Transradial Cardiac Catheterization and InterventionShahar Lavi0Asim Cheema1Andrew Yadegari2Zeev Israeli3Yaniv Levi4Sabrina Wall5Mistre Alemayehu6Yasir Parviz7Bogdan‐Dorian Murariu8Terry McPherson9Jaffer Syed10Rodrigo Bagur11London Health Sciences Centre, London, Ontario, CanadaSt. Michael's Hospital, Toronto, Ontario, CanadaLondon Health Sciences Centre, London, Ontario, CanadaLondon Health Sciences Centre, London, Ontario, CanadaLondon Health Sciences Centre, London, Ontario, CanadaLondon Health Sciences Centre, London, Ontario, CanadaLondon Health Sciences Centre, London, Ontario, CanadaLondon Health Sciences Centre, London, Ontario, CanadaLondon Health Sciences Centre, London, Ontario, CanadaLondon Health Sciences Centre, London, Ontario, CanadaLondon Health Sciences Centre, London, Ontario, CanadaLondon Health Sciences Centre, London, Ontario, CanadaBackgroundRadial artery occlusion is a known complication following transradial cardiac catheterization. A shorter duration of postprocedural radial clamp time may reduce radial artery occlusion (RAO) but might be associated with incomplete hemostasis. Methods and ResultsIn total, 568 patients undergoing transradial diagnostic cardiac catheterization were randomly assigned to either 20 minutes (ultrashort) or 60 minutes (short) hemostatic compression time using patent hemostasis. Subsequently, clamp pressure was reduced gradually over 20 minutes. Access site hemostasis and RAO were assessed after clamp removal. Repeated assessment of RAO was determined at 1 week in 210 (37%) patients. Mean age was 64±11 years, and 30% were female. Percutaneous coronary intervention was performed in 161 patients. RAO immediately after clamp removal was documented in 14 (4.9%) and 8 (2.8%) patients in the 20‐ and 60‐minute clamp application groups, respectively (P=0.19). The incidence of grade 1 hematoma was higher in the 20‐minute group (6.7% versus 2.5%, P=0.015). RAO at 1 week after the procedure was 2.9% and 0.9% in the 20‐ and 60‐minute groups, respectively (P=0.36). Requirement for clamp retightening (36% versus 16%, P=0.01) was higher among patients who had RAO. Need for clamp retightening was the only independent predictor of RAO (P=0.04). ConclusionsUltrashort radial clamp application of 20 minutes is not preferable to a short duration of 60 minutes. The 60‐minute clamp duration is safe and provides good access site hemostasis with low RAO rates. Clinical Trial RegistrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT02269722.https://www.ahajournals.org/doi/10.1161/JAHA.116.005029angiographycardiac catheterizationpercutaneous coronary interventionvascular complications |
| spellingShingle | Shahar Lavi Asim Cheema Andrew Yadegari Zeev Israeli Yaniv Levi Sabrina Wall Mistre Alemayehu Yasir Parviz Bogdan‐Dorian Murariu Terry McPherson Jaffer Syed Rodrigo Bagur Randomized Trial of Compression Duration After Transradial Cardiac Catheterization and Intervention Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease angiography cardiac catheterization percutaneous coronary intervention vascular complications |
| title | Randomized Trial of Compression Duration After Transradial Cardiac Catheterization and Intervention |
| title_full | Randomized Trial of Compression Duration After Transradial Cardiac Catheterization and Intervention |
| title_fullStr | Randomized Trial of Compression Duration After Transradial Cardiac Catheterization and Intervention |
| title_full_unstemmed | Randomized Trial of Compression Duration After Transradial Cardiac Catheterization and Intervention |
| title_short | Randomized Trial of Compression Duration After Transradial Cardiac Catheterization and Intervention |
| title_sort | randomized trial of compression duration after transradial cardiac catheterization and intervention |
| topic | angiography cardiac catheterization percutaneous coronary intervention vascular complications |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.116.005029 |
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